Introduction Intracranial hemorrhage during pregnacy can have catastrophic outcomes for both mother and fetus with high mortality rates (estimated 63% and 27% respectively) in untreated ruptured aneurysms. One of the most commonly expressed concerns about angiography during pregnancy is the potential risk of fetal abnormalities resulting from radiation exposure. We report direct measurement of ionizing radiation exposure over of the gravid uterus during cerebral arteriography.
Materials and methods Dose over the gravid uterus using a TLD was measured during endovascular treatment of an intracranial aneurysm. The patient's abdomen was shielded using lead aprons place anterior and posterior, and strategies for dose reduction implemented. Pubmed search using mesh terms pregnancy, radiation dose, endovascular therapy and CT was performed for literature review.
Results Dose measured over the gravid uterus was 11 MREM. In comparison to findings reported in the literature this level is significantly less than esposure over the uterus during CT of the abdomen to exclude appendicitis/nephrolithiasis and CT of the chest to exclude pulmonary embolism in pregnancy. The dose is similar to head CT exposure. Risk to benifit analysis for treatment of ruptured aneurysms favors treatment during pregnancy.
Conclusion Radiation exposure to the gravid uterus and fetus during cerebral angiography and endovascular procedures are within standard radiation exposure in pregnancy guidelines and comparible with other imaging modalities used during pregnancy. Diagnostic cerebral angiography and endovascular procedures can be safely performed during pregnancy while implementing radiation dose reduction strategies.
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