Can pregnant women undergo Computed Tomography (CT) scans?

From the Guidelines

Pregnant women should avoid undergoing Computed Tomography (CT) scans unless absolutely medically necessary, as the risks of radiation exposure to the developing fetus can be minimized with alternative imaging methods. The primary concern with CT scans during pregnancy is the potential risk of radiation exposure to the fetus, which may increase the risk of birth defects or childhood cancer 1. However, the estimated increase in cancer incidence following fetal exposure to 50 mGy is minimal, with an estimated increase of 1.1 to 3 per 1000 1. When a CT scan is deemed necessary during pregnancy, radiologists take special precautions to minimize radiation exposure, such as using the lowest effective radiation dose and considering alternative imaging methods first 1. Some key points to consider include:

• Ultrasound and MRI are preferred imaging options during pregnancy as they don't use ionizing radiation 1.
• If a CT scan is necessary, the benefits of obtaining crucial diagnostic information should outweigh the small potential risks to the baby 1.
• Healthcare professionals should consider the risk-benefit balance of exposure to radiological procedures and inform patients about the potential risks and benefits 1.
• The American College of Radiology Appropriateness Criteria outlines the specific risks based on gestational age and emphasizes the importance of obtaining informed consent from the patient before imaging is performed 1.

From the Research

Computed Tomography (CT) Scans in Pregnant Women

• CT scans can be performed on pregnant women, but the benefits and risks must be carefully weighed 2, 3, 4, 5, 6.
• The fetus is more sensitive to radiation due to its rapidly developing cell system, and exposure to radiation can increase the risk of childhood cancer and other complications 2, 4, 6.
• The use of CT scans in pregnant women is generally accepted when the potential benefits outweigh the risks, such as in cases of suspected acute appendicitis, pulmonary embolism, or trauma 3, 5.
• Alternative imaging modalities, such as ultrasound and MRI, may be preferred in some cases to minimize radiation exposure to the fetus 2, 4, 5.
• Radiologists and healthcare providers should discuss the risks and benefits of CT scans with pregnant women and obtain their consent before performing the procedure 2, 4, 5.

Safety Measures and Guidelines

• Fetal radiation doses up to 1 mGy are considered acceptable, but larger doses may increase the risk of carcinogenesis 4.
• The use of iodinated contrast agents is generally safe during pregnancy, but gadolinium-based contrast agents are controversial due to lack of human clinical data and potential toxicity 4, 5.
• Guidelines for the use of CT scans and contrast media during pregnancy have been developed to help radiologists and healthcare providers make informed decisions 4, 5.

Specific Indications for CT Scans in Pregnant Women

• Suspected acute appendicitis: CT scan may be performed if ultrasound is negative or inconclusive 3, 5.
• Suspected pulmonary embolism: CT scan is the initial diagnostic imaging modality of choice 5.
• Trauma: CT scan may be performed if serious injury is suspected 5.
• Renal colic: Ultrasonography is the initial study of choice, but CT scan may be performed if necessary 5.