Guidelines for diagnostic imaging during pregnancy

The American College of Obstetricians and Gynecologists 409 12th Street, SW, Various imaging modalities are available for diagnosis during pregnancy. These include X-ray, ultrasonography, magnetic resonance imaging (MRI), and nuclear medicine studies. Of these, diagnostic X-ray is the most frequent cause of anxiety for both obstetrician and patient. Much of this anxiety is secondary to a general belief that any radiation exposure is harmful and will result in an anomalous fetus. This anxiety could lead to inappropriate therapeutic abortion and litigation. In fact, most diagnostic radiologic procedures are associated with little, if any, known significant fetal risks. Moreover, according to the American College of Radiology, no single diagnostic X-ray procedure results in radiation exposure to a degree that would threaten the well-being of the developing preembryo, embryo, and fetus. Thus, exposure to X-ray during pregnancy is not an indication for therapeutic abortion (1, 2). Some women are exposed to X-rays before the diagnosis of pregnancy. Occasionally, X-ray procedures will be indicated during pregnancy for significant medical problems or trauma. To enable physicians to counsel patients appropriately, the following information is provided about the potential risks and measures that can reduce diagnostic X-ray exposure.