Often heard of female friends in the diagnostic radiation, such as chest x-ray, oral x-ray irradiation, or abdominal x-ray irradiation, found that the pregnancy, or during pregnancy because of the disease had to accept x-ray irradiation, so around friends and even many doctors told her that the exposure during pregnancy will cause fetal deformities, terminate the pregnancy before it is too late, induced abortion. No one wants to have an unhealthy child, so the joy and longing for a baby was immediately replaced by physical and psychological harm. A little life is snuffed out at the embryonic stage. I feel heartbroken every time I see it. Can irradiation 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 the most alarming to pregnant women and their families. This stems from the general public perception that x-ray exposure can harm the fetus or even cause teratogenesis. China’s liberal abortion policy has in turn led to the very common practice of pregnant women choosing abortion to avoid the possibility of teratogenesis. It is true that high doses of ionizing radiation such as x-rays can cause many serious injuries to the fetus, such as miscarriage, fetal growth disorders, cerebellar malformations, impaired mental development, and increased risk of malignant tumors in children. But are diagnostic x-rays dangerous? According to the clinical guidelines of the American College of Radiology, the American College of Obstetricians and Gynecologists, and the U.S. Food and Drug Administration, the vast majority of diagnostic x-rays do not cause fetal harm, and if they do, it is at a very, very low level. And the American College of Radiology clearly states that a single diagnostic x-ray does not even come close to the dose that would cause embryonic or fetal harm. So a single diagnostic x-ray exposure does not justify an abortion. I emphasize the word diagnostic here again and again, because the dose of therapeutic radiation can far exceed the dose of diagnostic radiation, and that’s a different matter. Some women are terrified because they have been exposed to radiation for some reason before they know they are pregnant, and this, coupled with the wrong advice from some doctors as well, causes these women to bite the bullet and choose abortion for the sake of a healthy child. Once a child is conceived, there is still the possibility that certain diseases or accidents may require the use of x-rays to make a correct diagnosis. Let’s take a look at the data to see if diagnostic tests can cause fetal damage or even teratogenesis. An x-ray exposure of less than 50 mGy (gy is a unit of radiation dose; 1 gy is equal to 100 rad, and 50 mGy is 5 rad, which is equal to 5000 millirad) will not cause any health effects to the fetus. Fetal health problems can only occur with exposures higher than 100 mGy, especially between 8 and 25 weeks of gestation, which is the most sensitive period. 100 mGy is a dose that would not be used for diagnostic x-rays except for barium enemas, serial imaging of the small bowel, or radiation therapy. According to the American Association of Radiology and the Maternity Association, a single chest x-ray of a pregnant woman exposes the fetus to a dose of 0.02C0.07 mrad. Remember, it takes more than 5,000 mrad to cause fetal damage. A single abdominal radiograph exposes the fetus to 100 millirad, and a pyelogram may expose the fetus to more than 1 rad. mammography exposes the fetus to 7-20 millirad. barium enema or small bowel serial imaging exposes the fetus to 2-4 rad. head and chest CT exposes the fetus to less than 1 rad. abdominal or lumbar spine CT scans expose the fetus to less than 1 rad. CT scan of the abdomen or lumbar spine can expose the fetus to up to 3.5 rad. Plain radiographs usually expose the fetus to very small doses. When x-rays are done during pregnancy, the abdomen is usually protected with a protective garment containing lead, which further reduces the dose. With the exception of barium enema and serial imaging of the small bowel, most contrast fluoroscopy exams result in a dose to the fetus of only millirad, and the amount of radiation exposure and the distance to the film from the CT will vary. Pelvic CT may expose the fetus to as much as 1.5 rad, but radiologists can reduce this to closer to 250 mrad by using low-dose techniques. In late 2013, the American College of Obstetricians and Gynecologists published new guidelines on dental care during pregnancy, which for the first time unambiguously stated that early oral health care, oral cleanings, including dental x-rays, are recommended during pregnancy. Routine dental x-rays, head x-rays, extremity x-rays, and chest x-rays, including mammograms, or CT of the head and chest are not likely to cause fetal harm, and the increased risk of childhood cancers is negligible. Please discuss with your doctor if you need an abdominal exam. Therefore, if you need an x-ray during pregnancy due to illness or trauma and there is no better alternative, you do not need to refuse an x-ray for fear of risk to the fetus. Your health is the most important thing not only for yourself but also for your child. Can exposure to radiation before pregnancy affect the fetus? 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 issue, meaning that if the fetus survives, there is no problem. What happened to the pregnant women who did receive chest x-rays and ended up with a deformed child? Remember, without irradiation, the same 4-6% of newborns will have various kinds of malformations, but the vast majority are minor, such as birthmarks, an extra finger or toe, etc. The child having malformations is not a result of diagnostic radiation. Is ultrasound harmful to the fetus? Ultrasound uses a sound wave, not an ionizing ray. To date, there have been no reports of fetal injury from diagnostic ultrasound, including Doppler ultrasound. Ultrasound is safe during pregnancy, which is why modern obstetrics and gynecology departments routinely use ultrasound instead of x-rays. Is MRI safe? MRI also does not use ionized radiation, but instead uses a magnetic field to change the energy state of hydrogen ions in the body. Therefore, there is no risk of damage to the fetus. Therefore, MRI is the best choice when it is necessary to check the development of the central nervous system of the fetus or to diagnose placental abnormalities such as placenta previa. The guidelines about x-ray during pregnancy are: 1. Pregnant women should be informed that a single x-ray is harmless. An x-ray exposure of less than 5 rad will not cause fetal damage or teratology. 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 examination. 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 dose to which the fetus may be exposed 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. Their use should only be considered if it is ensured that the benefits of their use far outweigh the possible damage to the fetus. For pregnant women the following are precautions: 1. First, and most importantly, if you are pregnant, or suspect pregnancy, tell your doctor. This will be important not only for x-ray exposure, but for other medication choices. 2, If you need an x-ray during your pregnancy, remember to tell your doctor if you’ve had a similar test recently. Maybe the test can be skipped this time. 3, In short, if you are pregnant, or suspect pregnancy, consult your doctor for any aspect of the test. But unnecessary unnecessary worry is not a reason for abortion.