Challenges were faced during radiography of pregnant women

INTRODUCTION

Radiography involves using x-rays to create images of the inside of the body, which provides information about diseases. During pregnancy, women’s body frequently changes and can face various diseases which can be diagnosed with radiography. during radiography people may be exposed to large amount of “high potential energy’’ radiation much more than we get from everyday exposure like X-rays. Exposure to large amount of high energy radiation or ionizing radiation can cause harmful effects on people. However, when it comes to pregnant women, there is concern about the potential risk associated with exposing the foetus to radiation. during pregnancy the developing foetus is more sensitive to radiation exposure This is because the foetal cells are dividing and growing quickly, when the organs are forming. high doses of radiation can increase the risk of birth defects like- stunted growth, deformities, abnormal brain function, cancer may develop sometimes later in life.¹

The possibility of severe health effects depends on the gestational age of the foetus at the time of radiation exposure and the amount of radiation it is exposed to Foetus is highly sensitive to radiation during their early development between 2nd and 18th week of pregnancy. Women have an increased risk of foetal miscarriage.² The health effects to the foetus can be severe even the radiation exposure doses is too low to make the mother sick. Fetus is less sensitive to radiation exposure during later stages of pregnancy (after 18 weeks).³

REVIEW

The general principle for imaging during pregnancy is similar to imaging for the general public, with the goal of radiation exposure being as low as reasonably achievable (ALARA).

Generally, ALARA principle includes the time of exposure, position of the patient as much as possibly away from the X-Ray source, using the correct shielding equipment.

Risk vs benefit assessment

Radiography of pregnant patients is typically deferred. Until after the 1st trimester as this is when the foetus is most vulnerable to radiation induced harm. However urgent diagnostic needs may necessitate imaging during any stage of pregnancy.

In such cases the benefits of the procedure must outweigh the risks and the lowest possible radiation dose should be used.⁶

This article explores the several challenges that healthcare professionals need to consider to ensure the safety of both the mother and the developing fetus. During radiography of pregnant women.

Minimizing radiation exposure

The primary concern is to minimize radiation exposure to the foetus. Radiography involves the use of ionizing radiation, which can be harmful to the developing baby, especially during the first trimester when organs are forming. Techniques such as shielding the abdomen with lead aprons and using the lowest possible radiation dose are essential while obtaining diagnostic images. using collimation to focus the X-ray beam solely on the area of interest help to reduce unnecessary exposure.

Diagnostic dilemma

Balancing the need for diagnostic information with the safety of the mother and developing foetus can be challenging. Healthcare providers must determine the most appropriate imaging modality that can provide the required diagnostic information which causes the least risk to the foetus.

In some cases, alternative imaging techniques that do not use ionizing radiation, such as ultrasound or magnetic resonance imaging (MRI) may be preferred over X-rays or CT scans to avoid any potential harm to the developing baby.

Timing of the examination

If radiography is necessary, it is generally recommended to perform it during the second trimester when the risk to the foetus is lower compared to the 1st trimester. However, if urgent imaging is needed, it can be done at any stage of pregnancy with proper precautions.⁷

Proper positioning

Ensuring proper positioning of the patient during the radiographic procedure is crucial to obtaining accurate images while minimizing radiation exposure to the foetus. This may involve using additional support or cushions to maintain the correct posture.

Image quality

Factors such as increased abdominal thickness and foetal movement can affect image clarity and accuracy. To overcome this, Use the lowest radiation dose necessary to obtain diagnostic images. This can be achieved by adjusting technical factors like exposure time, mA, and kVp.⁸

Communication with the patient

Radiation in diagnostic imaging can provoke feelings of anxiety and nervousness in pregnant women, and it is important to counsel these women prior to the examination. Communication with the pregnant patient is crucial throughout the process. Clear and transparent communication about the procedure, associated risks, and the precautions taken to minimize radiation exposure can help alleviate concerns and empower the patient to make informed decisions regarding their healthcare.

CONCLUSION

Overall, the key in radiography of pregnant women is to carefully weigh the risks and benefits, use appropriate safety measures to minimize radiation exposure, and ensure clear communication with the patient to make informed decisions about their care. By addressing all these challenges thoughtfully and implementing appropriate safety measures, healthcare providers can ensure the well-being of both the pregnant woman and her foetus during radiographic procedures.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: Not required

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