X-rays and Pregnancy (RADS 349)

the potential response to radiation exposure in utero depends on:

both time and intensity

The most sensitive time in anyone's life is...

before birth, so fetus is more sensitive earlier in life than later (1st trimester)

Exposure during 1st - 2nd weeks of pregnancy

the only only biological effect, if any, is reabsorption of the embryo (spontaneous abortion), there is no concern of congenital abnormalities

reabsorption of the embryo, occurs when exposed during the 1st and 2nd weeks of pregnancy

Spontaneous abortion

High radiation exposure during 2nd - 10th weeks of pregnancy can result in:

congenital abnormalities

High exposure early in the 2nd - 10th weeks of pregnancy results in

skeletal deformities

High exposure late in the 2nd - 10th weeks of pregnancy results in

neurological deficiencies

2nd-10th week of pregnancy is known as...

major organogenesis - organ systems are developing

High exposures during the 2nd or 3rd trimesters, can result in:

-childhood malignant diseases such as leukemia

- occur in utero as a dose of more than 2 Gy

The most critical time period for pregnancy is

the first trimester

Intensity or amount (Dose Factor) of pregnancy, no response will occur if it's...

less than 250 mGy

At doses of 100 mGy results in

1% chance of congenital abnormalities, and a 0.1% risk of reabsorption of embryo

Technologists who become pregnant SHOULD

notify the supervising technologists immediately

-only this because it violates federal law to require someone to inform you of their pregnancy

DEL or EDL for fetus is

5 mSv for entire gestation, and no more than 0.5 mSv/month

Pregnant Technologists apron

1 mm Pb aprons, usually not advisable because of weight (22lb), but they're maternity aprons reducing the weight because only a band on 1 mm Pb

Reasonable Accommodations concerning pregnant technologists

-provide a 2nd personnel monitoring device

-incorporate a 3-step program

2nd personnel monitoring device for pregnant technologists

-worn at the abdomen under the Pb apron

-exposure on this dosimeter is recorded separate and identified as exposure to the fetus

If 2nd personnel monitoring device is not available for pregnant technologist you can...

estimate the fetal dose by using the amount calculated at the collar level

Calculating Fetal Dose

10% of this dose the abdomen skin dose, then take 30% for fetal dose

review pregnancy policy

new employee indoctrination (1st step)

at least 2 in services per year geared to radiation protection, with a section on the potentially pregnant employee

in-service training (2nd step)

always start with a review of exposure history of the employee

-under no circumstances should termination or involuntary leave of absence occur

-counseled and signs a form indicating proper counseling

counseling during pregnancy (3rd step)

Pregnant technologist who works in the following areas must take special precautions:

-special procedure and fluoroscopy

-radiation oncology employees

-nuclear medicine

-sonography

X-Ray Pregnant Patient

never knowingly perform radiologic procedures, unless documented decision to do so has been made in

When adequate protective measures are taken...

it is nearly impossible to reach the fetal DEL

The practice of waiting 10 days after a woman's menstrual flow to do a radiological exam because it is the most improbable a women could be pregnant

10-day rule

Which rule is considered obsolete for pregnant patients by some?

the 10-day rule because it results in unnecessary postponement of an examination

risk to fetus exposed during the first 4 weeks is so small there is no need to limit the exposure during the 4 weeks

-believe the all or none effect will take place (spontaneous abortion or child will be carried to term with no effects)

28-day rule