Dilemma in radiological examinations of pregnant women

Abstract

Ionizing radiation is electromagnetic or particle radiation that has sufficient energy to cause ionization of atoms. The effects of radiation depend on the energy and type of radiation, the matter through which the radiation passes, the radiation dose and the phase of the cell cycle. The nature of ionizing radiation contributes to the importance of the topic of radiological examinations of pregnant women, i.e. the possible risk for pregnancy and the fetus. The risk of fetal damage depends on the absorbed dose of radiation and the stage of pregnancy. The risk is highest during organogenesis and in the early fetal period, it is slightly lower in the second trimester and the lowest during the third trimester of pregnancy. The aim of this review article is to present the dilemmas and ethical problems faced by clinicians and pregnant women in everyday radiological practice. The radiologist is obliged to inform the patient about the planned procedure, the way it is performed and possible complications, but communicating the diagnosis and proposing therapy, if necessary, should be the responsibility of the doctor who referred the patient for examination. When considering the use of radiation in pregnant women, the International Commission on Radiological Protection advises that the fetus be considered a member of the general population and that general radiation dose limits apply. Accordingly, in evaluating the risks and benefits of medical radiation exposure, two persons must be considered, the mother and child. When everything is taken into account, the risk of a radiological examination for the pregnant woman and the fetus, i.e. the relationship between the benefit and the risk is assessed in relation to each individual case separately, in agreement between the doctor, the pregnant woman and other interested persons.