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(Reuters Health) – Women who are unaware of their pregnancy when they undergo magnetic resonance imaging (MRI) may be exposed to a chemical that might not be safe for the fetus, warns one. new report.
The chemical, a dye called gadolinium contrast agent, is used in approximately 30-45% of MRI scans in the United States to help improve differences in internal organs, soft tissues, blood vessels and bones .
"It is known that contrast to gadolinium crosses the placenta and enters the fetal circulation," said Steven Bird, lead author of the study, Center for Evaluation and Drug Research at Silver Spring , in Maryland.
The safety of gadolinium-based contrast agents, or GBCA, in pregnant women "has not been established, and their use during pregnancy is not recommended unless it is essential for good health. of the woman or fetus, "Bird told Reuters Health by email. "Available data from cohort studies and case reports have revealed conflicting findings regarding the association between GBCA and adverse effects on the fetus."
Bird and his colleagues used the FDA-funded Sentinel Distributed database to analyze data from almost 4.7 million pregnancies that resulted in live births between 2006 and 2017. They searched for prevalence of HIV-related procedures. 39 MRI with and without GBCA in pregnant women, including quarter and location of scan on the body.
The research team discovered 6,879 exposures to GBCA in 5,457 pregnancies, representing a GBCA review for 860 pregnancies, or about 0.1% of all pregnancies. Half of the MRIs consisted of head examinations, but 22% involved the pelvic and abdominal areas, which was more likely to affect the fetus.
About 70% of exposures to pregnant women occurred during the first trimester, the study authors wrote in the journal Radiology.
The finding that most pregnancies with in utero exposure to gadolinium was found during the first few weeks, "while a woman may not be aware of her pregnancy … Stresses the importance to the Patients and health professionals evaluate the possibility of a pregnancy before the administration of the GBCA, "Bird said.
"Increased attention to pregnancy screening measures could help reduce inadvertent exposure to gadolinium," Bird said. "Health care providers should only use GBCAs when additional diagnostic information provided by contrast is needed."
Bird and her colleagues are collaborating and funding a follow-up study of pregnant women to evaluate fetal and neonatal outcomes after exposure to GBCA during pregnancy. The FDA will also continue to monitor reports of adverse events, he said.
The American College of Radiology recommends testing women of childbearing age for pregnancy before any MRI, and states that GBCA should only be used after careful consideration of the fact that the benefits for the mother and the fetus outweigh the potential risks.
"Gadolinium-based contrast agents are increasingly being used in magnetic resonance imaging," said Javier Lafuente of the Gregorio Maranon Hospital in Madrid, Spain. Lafuente, who did not participate in this study, did research on GBCA in MRI.
"In general, these compounds are safe," he said. Nevertheless, he added, even in non-pregnant patients, "adverse reactions, the possibility of nephrotoxicity related to these compounds and the possibility of nephrogenic systemic fibrosis might have contraindications to their clinical use ".
SOURCE: http://bit.ly/2KIp6C2 Radiology, online August 20, 2019.
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