The Pennsylvania Patient Safety Authority has just released a new advisory that examines the risk to pregnant women who received x-rays during the initial stages of pregnancy, when the patients were not aware they were pregnant. According to the advisory, half of North American pregnancies are unplanned, leading to concern over the prenatal effects from x-rays.

However, studies indicate the risks of radiation effects are variable, depending upon certain factors-such as whether the patient has had multiple x-rays, the amount of radiation in a particular procedure, the risk related with the procedure and the stage of gestation at the time of the dose. The potential of prenatal damage by x-rays, CT scans and fluoroscopy tests is generally low, according to the Authority's guides.

Research on radiation doses has shown that a properly performed procedure does not notably affect fetal development, death, complications or malformation. In fact, the risk is generally higher for a mother to forgo a diagnostic radiology examination than for harm to the fetus, if the examination is necessary for diagnosis and treatment.

John Clarke, M.D., clinical director of the Authority, offered strategies for the prevention of unnecessary x-rays and of limiting exposure in medically necessary x-rays of pregnant women. These strategies include evaluating if the procedure is in fact necessary, analyzing the risks to a patient exposed to diagnostic x-rays, and physicians becoming more aware of the effects of differing radiation doses in order to counsel patients effectively. These approaches may prevent unnecessary anxiety and fear in pregnant women, and unnecessary termination of pregnancy.

The Authority's other key points to physicians are consideration of safer alternate procedures during pregnancy such as MRIs and ultrasound reading, and urging that pregnant women be informed in writing of the radiation dose and date of the procedure in order to keep track of cumulative effects. The Authority's website offers resources to educate patients regarding radiation and tracking cumulative exposure of radiation.

More information on the Pennsylvania Patient Safety Authority's report can be found here and here.

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