Safety of radiation exposure during pregnancy in COVID-19 affected women

Abstract

Radiologic imaging in the evaluation of pregnant patients has significantly grown with the outbreak of the severe acute respiratory syndrome related to SARS-CoV-2 pandemic. Lung ultrasound is an emerging non-invasive bedside technique used to diagnose interstitial lung syndrome through evaluation and quantitation of the number of B-lines, pleural irregularities and nodules or consolidations. In pregnant COVID-19 patients, lung ultrasound should be considered on account of its various strengths, such as its being easily carried out bedside by trained sonographers for the monitoring of lung involvement in follow-ups, and its repeatability and affordability. However, pregnant patients could need chest radiography or computed tomographic (CT) examinations for the diagnosis of pneumonia. Concerns and misconceptions about potential radiation-related risks for the embryo or fetus are still widespread among clinicians and can lead to excessive anxiety among patients. Several well-recognized guidance documents were published in the last years as to the safety of a single-phase CT or an X-ray chest and related carcinogenic and teratogenic risk. This paper summarizes the safety of radiological examination for pneumonia in pregnant women affected by COVID 19, based on the estimated embryo-fetal radiation absorption per procedure (mGy).

Obstetrics Changes Caused by Covid-19

“…Pregnant women with suspected pneumonia or severe illness due to COIVD-19 should not be denied imaging diagnostic based on chest radiography, or computed tomography pulmonary angiography (CTPA) where indicated [16,17]. Concerns and misconceptions about potential radiation-related risks for the embryo or fetus are still widespread among clinicians and can lead to excessive anxiety among patients, but evidence has showed the safety of these procedure and it's a medical duty to reassure women that the radiation dose during single chest CT or even CT pulmonary angiogram is much lower than the one potentially causing fetal complications [18,19].…”