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Web-Based Curriculum & Reference  
Editors
Kurt J. Pfeifer, MD, FACP
Steven L. Cohn, MD, FACP
 
Medical College of Wisconsin
State University of New York - Downstate
 
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  Pregnancy
Michael P. Carson, MD & David A. Halle, MD
 
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    PREOPERATIVE EVALUATION
    Diagnostic Testing
     

     
    • As in all settings, ask yourself how your treatment of the patient would be affected if you did NOT obtain the test.
    • If the results will clearly affect treatment and benefit the mother, order the test.
    Radiographic Studies
    • Although fetal radiation exposure should always be considered when ordering radiographic studies, the risk from most is relatively small (see table on right).
    • The rate of leukemia in children is about 3.6/10,000.  A fetus would have to be exposed to 1 or 2 rads before the risk increases by 1 case per 10,000 children.
    • Iodinated CT contrast is safe during pregnancy and lactation. [8,9]
    • MRIs can be obtained but avoid gadolinium as it stays in the amniotic fluid and the effects are not known.

     
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    FETAL RADIATION EXPOSURE

    STUDY FETAL RADIATION EXPOSURE (rads) # Maternal Studies Permissible During Pregnancy
    CXR with shielding <0.0007 70,000
    Ventilation-perfusion scan 0.2 25
    Head CT* 0.05 100
    Chest CT* 0.1 50
    Abdominal CT* 2.6 1
    * 10 slices
    		 
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