Irradiación y gestación ¿una verdadera necesidad?

Abstract

Background: It is known that multiple pathologies during pregnancy require
diagnostic support by imaging, so it is necessary to know when and which
protection techniques should be used. Furthehave the information corresponding to the possible adverse effects of exposure of the
mother and the fetus to ionizing radiation from these diagnostic techniques to make the
right choice, to perform a balance between risk and benefit that prevents exposing the
patient to unnecessary radiation, and to reach a consensus on the procedure between the
medical team and the pregnant woman and her family.
Objective: This review aims to identify the important information reported in recent years
regarding the need for exposure to ionizing radiation from diagnostic imaging during
pregnancy, as well as its adverse effects on the fetus and the mother, and the usefulness of
various diagnostic methods in different common pathologies in pregnancy.
Materials and methods: A systematic literature search was conducted from January 2018
to January 2021 in PubMed, ScienceDirect, Journal of the American Medical Association
(JAMA) and Google Scholar databases, concerning the MeSH terms (Medical Subject
Headings): pregnancy, radiation (ionizing), diagnostic imaging, radiation exposure,
radiography and tomography, and non-MeSH: gestation, pregnancy, diagnostic imaging
with ionizing radiation, teratogenicity and ionizing radiation. Systematic literature review,
cohort, case-control and case report articles were considered. A total of 37 articles were
included in this review related to the use of ionizing radiation imaging in pregnant women,
as well as its adverse effects, indications and contraindications.
Results and conclusions: The safety of diagnostic imaging used during gestation depends
on the fetal dose absorbed, the stage of fetal development at which they are obtained, and
the type of imaging used. Although the conventional diagnostic methods generally used do
not exceed the limits considered teratogenic, it is advisable to prioritize the use of images
that do not require ionizing radiation. When there is a medical indication for diagnostic
imaging, its performance should not be postponed for fear of the ionizing radiation, but
early diagnosis and treatment of the pathology should be sought in order to improve the
chances of maternal and fetal survival, as well as to reduce morbidity in the pregnant
women.rmore, the professional needs to