[ RadSafe ] In utero dose

[Mary Aldrich]

This is an occupational dose limit only and only for a declared pregnancy...
it isn't appropriate to use it as a limit in decision tree for patient
diagnosis and treatment.

As for the decision to be made when "there is a pressing need to preserve
health" if you don't preserve the mother, the fetus is a non-issue.

In my experience, physicians have contacted HP's for guidance on the dose
delivered by a particular x-ray series after the fact.

Regards
M. Aldrich















The general rule of
thumb for In Utero Dose is 500 millirem for the term of the pregnancy,
but of course all exposure should be kept ALARA. 10CFR20 has additional
federal limits.

Floyd W. Flanigan B.S.Nuc.H.P.

-----Original Message-----
From: radsafe-bounces at radlab.nl [mailto:radsafe-bounces at radlab.nl] On
Behalf Of Keith Welch
Sent: Tuesday, April 18, 2006 8:49 AM
To: radsafe at radlab.nl
Subject: [ RadSafe ] In utero dose

I have some questions for you medical experts.  I'm curious what
guidelines are used when there is a case requiring x-rays of a pregnant
female.  Let me give you a hypothetical case.  Let's say a woman is
injured in an auto accidedent, has some internal injuries and broken
bones.  She's 12 weeks pregnant.  To treat her injuries, she needs
surgery and a series of radiographs.  Are there generally accepted and
well known standards that physicians refer to in order to advise
patients and determine a course of treatment?  ARe there risk-based
guidelines in place and widely known to general surgeons and
practicioners?  How common is it for a surgeon to seek the advice of an
HP or MP to assess the risks of such procedures?   My impression of the
handling of "routine" x-rays is that if a woman is pregnant, x-rays are
always postponed, just to be conservative.  But in a case where there is

a pressing need to preserve health, how is the decision to conduct the
x-rays arrived at?  How are these risks weighed?  What is the typical
"standard of care"?  Is there an agreed dose at which the patient is
advised to terminate the pregnancy?

Thanks.
Keith Welch

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