Fetal radiation dose in prophylactic uterine arterial embolization.

Abstract

PURPOSE:

The purpose of the study was to estimate the absorbed dose (AD) to the fetus for pregnant patients with placenta accreta undergoing fluoroscopy imaging during prophylactic catheterization and uterine artery embolization. We hypothesize that after optimizing the use of the radiation, this endovascular method is safe.

METHODS:

Catheterization was performed for seven women before their elective cesarean section. The correct position of the catheter was confirmed by a radiologist using a small bolus of contrast medium and optimized pulsed fluoroscopy imaging. For the AD measurements of the fetus, four radiophotoluminescence dosimeters were placed in the vaginal fornix. Dose area product (DAP), entrance skin exposure (ESE), fluoroscopy time (Tf), and dose rate also was recorded.

RESULTS:

The mean values of the radiation exposure for the seven patients were as follows: AD in the vaginal fornix was 11.2 (range 2.2-28.7) mGy, DAP 1,122 (648-2,001) cGy cm(2), ESE 120 (63-184) mGy, Tf 7:31 (5:05-11:35) min:sec, and dose rate 15 (8-21) mGy/min, respectively.

CONCLUSIONS:

This study revealed that the AD to the fetus due to the endovascular method can be reduced to be below the risk for developmental disorders when pulsed fluoroscopy with an optimized protocol is used without angiography exposures.

• Authors: Anna-Leena Manninen, Kati Ojala, Miika T Nieminen, Jukka Perälä
• Journal: Cardiovascular and interventional radiology (Cardiovasc Intervent Radiol) Vol. 37 Issue 4 Pg. 942-8 (Aug 2014) ISSN: 1432-086X [Electronic] United States
• PMID: 24258318 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Contrast Media

Topics

• Adult
• Contrast Media (administration & dosage)
• Female
• Fetus (radiation effects)
• Fluoroscopy
• Humans
• Placenta Accreta (therapy)
• Pregnancy
• Radiation Dosage
• Thermoluminescent Dosimetry
• Uterine Artery Embolization
• Vagina (radiation effects)