pregnancy and contrast media - Société Française de Radiologie

RECOMMENDATION FOR THE USE OF CONTRAST MEDIA
PREGNANCY
AND CONTRAST MEDIA
PRESENTATION
Imaging examinations requiring the administration of contrast agents pose two
problems for the pregnant woman: the irradiation or exposure to a magnetic field
of the embryo and the foetus, and the possible diffusion of the contrast agent
through the placenta. Very few studies are available on that issue, but prudence
should prevail.
The problem of irradiation has been studied by a group of experts under the aegis
of the Société Française de Radiologie and the Office de Protection contre les
Rayonnements ionisants. The conclusions can be read on the website of the SFR: la
SFR > Groupes de Travail >DG Euratom 97/43 > Guide des procédures radiologiques: critères de qualité et optimisation des doses.
In this text, we tackle the problem of contrast media administration
IODINATED CONTRAST MEDIA
No teratogenic effects were found in vivo with iodinated contrast media tested in
animals.
If an examination with injection of iodinated contrast media is done after 12 weeks
of amenorrhea, the punctual excess of iodides following the administration of
contrast media can lead to transitional foetal thyroid malfunction (usually hypothyroidism.)
MRI CONTRAST MEDIA
There are not enough data about the pregnant woman. As a consequence, the
administration of an MRI contrast agent is not advised, but an injection can be done
once risks and benefits have been weighed.
2 MRI contrast agents have proved toxic in animals:
dimeglumine gadobenate (Multihance®): studies on animals have revealed toxicity on reproductive functions. The potential risk for humans is unknown.
Multihance will not be used during pregnancy except in cases of absolute necessity.
mangafodipir (Teslascan®): studies on rats have revealed teratogenic effects and
studies on rabbits foetotoxicity and embryo toxicity. Thus, Tescalan should not be
used on pregnant women.
Version 1 - Avril 2005
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CIRTACI - RECOMMENDATION FOR THE USE OF CONTRAST MEDIA
PREGNANCY AND CONTRAST MEDIA
ADVICE/RECOMMENDATION
By virtue of the principle of precaution:
Except for echographs, every non-emergency examination that can be delayed
until birth should be postponed.
When imaging examination is essential, and if the administration of contrast
media is necessary, the examination can be done at any time of the pregnancy.
If a pulmonary embolism is suspected, an angioscan should be used rather than
a pulmonary scintigraphy because it irradiates less.
The paediatric team should be told about the administration of iodinated
contrast media when it happens after 12 weeks of amenorrhea (when the foetal thyroid starts picking up iodine) so that they can check the thyroid function in the neonate.
REFERENCES
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systématique. Gynecol Obstet Biol Reprod 1997 ; 26 : 90-4
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Plantin-Carrenard E, Beaudeux JL. Physiopathologie de l'iode : intérêt actuel de son dosage en biologie clinique. Annales de biologie clinique 2000; 58 : 395 - 401
Rofsky NM, Pizzarello DJ, Weinreb JC, Ambrosino MM, Rosenberg C. Effect on fetal mouse development of exposure to MR imaging and gadopentate dimeglumine. J Magn Reson Imaging 1994 ; 4 :
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radiation dose with helical CT. Radiology 2002 ; 224 : 487-92
Comité Interdisciplinaire de Recherche et de
Travail sur les Agents de Contraste en Imagerie
Version 1 - Avril 2005
Société Française de Radiologie
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