Born with a Tan

December 19th, 2008 | Sources: MedPageToday

Driven by a marked increase in CT scanning, overall utilization of X-ray imaging in pregnant women has doubled in the last 10 years, according to a study presented at the RSNA meetings.

Elizabeth Lazarus and colleagues studied data from 5,235 radiology exams done on 3,249 women in the decade between 1997 and 2006. They found that CT utilization increased 25% per year during the decade. Use of plain x-ray tests and nuclear medicine studies increased 7% and 10% respectively.

The most frequent reason to order a CT scan was for the evaluation of headache (37%), a common symptom during pregnancy. Head CTs expose the fetus to less than 1 mGy of ionizing radiation.

But 32% of CT referrals were for abdomino-pelvic studies, typically to rule-out appendicitis. In these studies fetal exposure approximates 20 mGy.

Lazarus indicated that the standard allowable threshold for the fetus is 50 mGY. “So even abdominal studies were well within allowable bounds,” she told MedPageToday.

Of course no one really knows this for sure, and the time during pregnancy when the fetus is exposed has to play a role, although this wasn’t analyzed. Then there’s the matter of repeat scans during pregnancy, which did occur in some patients.

The study also did not report on the percentage of scans that actually changed care plans.

The American College of Radiology has published guidelines for using x-rays during pregnancy. The extent to which these guidelines were followed in this survey is also unknown.

No one believes that pregnant women became sicker during the study period, or that utilization of CT scanning at the beginning of the decade had been inappropriately low, by the way.


 

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