I often hear that after receiving diagnostic radiation, such as chest x-ray, oral x-ray, or abdominal x-ray, a woman finds out that she is pregnant or has to receive x-ray during pregnancy due to illness. No one wants to have an unhealthy child, so the joy and hope for the baby was immediately replaced by physical and psychological damage. A little life is killed in the embryonic stage. I feel heartbroken every time I see it.
1. Can exposure to radiation during pregnancy really affect the fetus?
The radiological diagnostic measures that you may receive during pregnancy for diagnostic purposes are x-ray irradiation, ultrasound, MRI, CT scan, or nuclear medicine diagnosis. Of these, x-ray exposure is the most common and most likely to cause alarm to pregnant women and their families. This stems from the common public perception that x-ray exposure can harm the fetus and even cause malformations. China’s liberal abortion policy has in turn led to the very common choice of abortion by pregnant women to avoid the possibility of malformation.
Indeed, high doses of ionizing radiation such as x-rays can cause many serious damages to the fetus, such as miscarriage, fetal growth disorders, microcephaly, mental retardation, and increased risk of childhood malignancies.
Guidelines for medical treatment of x-ray examination during pregnancy
2. But are diagnostic x-rays dangerous?
According to the clinical guidelines of the American College of Radiology, the American College of Obstetrics and Gynecology, and the U.S. Food and Drug Administration, most diagnostic radiological examinations do not cause fetal harm, and if they do, it is very, very low. The American College of Radiology clearly states that the dose of exposure from a single diagnostic x-ray does not reach a dose that would cause embryonic or fetal harm. Therefore, a single diagnostic x-ray does not justify an abortion. I emphasize the word diagnostic again and again here, because the dose of therapeutic radiation can far exceed that of diagnostic radiation, which is a different matter.
Some women have been exposed to radiation for some reason before they knew they were pregnant, and the fear and misguided advice of some doctors has led these women to bite the bullet and choose abortion for the sake of a healthy child. Once a child is conceived, it is still possible that some disease or accident may require the use of x-rays to make a correct diagnosis. Let’s look at the data to see if diagnostic tests can cause fetal damage or even malformations.
The fetus receives x-ray exposure if the dose is less than 50 mGy (gy is a unit of radiation dose, 1 gy is equal to 100 rad, 50 mGy is also 5
rad, equal to 5000 mrad) will not cause health effects to the fetus. A dose of 100 mGy is not used at all in normal diagnostic x-ray exposure, except for barium enema, small intestine continuous imaging, or radiotherapy when such a high dose is possible.
3. So, it can be summarized.
Routine dental x-ray, head x-ray, extremity x-ray, and chest x-ray, including mammogram, or head and chest CT are not harmful to the fetus, and the increased risk of cancer in childhood is negligible. Please discuss with your doctor if you need an abdominal exam. Therefore, if you do need an x-ray during pregnancy due to illness or trauma and there is no better alternative, there is no need to refuse the test for fear of risk to the fetus. Your health is of utmost importance not only to yourself but also to your child.
4.Will the fetus be affected by exposure before I know I am pregnant?
If a woman is exposed to x-rays higher than 10 rads within the first two weeks of pregnancy, it may kill the embryo. But this is a 0 or 1 problem, which means that if the fetus survives, there will be no problem.
5. But what happens when a pregnant woman does receive a chest x-ray and her baby is deformed?
Remember, without exposure, the same 4-6% of newborns will have various types of malformations, but the vast majority will be minor, such as a birthmark, an extra finger or toe, etc. A child with malformations is not the result of diagnostic radiation.
6. Is ultrasound harmful to the fetus?
Ultrasound uses a sound wave, not an ionizing ray. So far, there has never been a report of fetal damage caused by diagnostic ultrasound, including Doppler ultrasound. Ultrasound is safe during pregnancy, which is why modern obstetrics and gynecology maternity exams do not use x-rays, but routinely use ultrasound.
7. Is MRI safe?
MRI also does not use ion rays, but uses a magnetic field to change the energy state of hydrogen ions in the body and imaging. Therefore, it will not cause damage to the fetus. Therefore, MRI is the best choice when you need to check the development of the fetal central nervous system or to confirm placenta abnormalities such as placenta previa.
8. Specific guidelines given by the American College of Obstetrics and Gynecology regarding x-ray examinations during pregnancy.
1) Pregnant women should be informed that a single x-ray examination is harmless. An x-ray exposure of less than 5 rad will not cause fetal damage or cause malformations.
2) If diagnostic x-ray exposure is needed for diagnostic testing during pregnancy, concerns about high doses of radiation should not be a reason to prevent or forgo the test. However, if possible, other alternative tests, such as ultrasound or MRI, can be considered instead of x-ray.
3) Ultrasound or MRI is safe during pregnancy.
4)If multiple x-ray exposures are required, a radiologist should be consulted to calculate the total possible dose of exposure to the fetus in order to guide the diagnosis.
5)The use of radioactive iodine isotopes during pregnancy is contraindicated and should not be used.
6)Radioactive contrast agents should be avoided if possible. It should only be considered if the benefits of its use are far greater than the possible damage to the fetus.
9. For pregnant women the following are precautions.
1) First, and most importantly, tell your doctor if you are pregnant, or suspect pregnancy. This will be important not only for x-ray exposure, but also for other medication choices.
2) If you need x-rays during your pregnancy, remember to tell your doctor if you have had similar tests recently. Maybe the test can be saved this time.
3) In conclusion, if you are pregnant, or suspect pregnancy, consult your doctor, no matter what aspect of the test is being done. But unnecessary worrying is not a reason to have an abortion.