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Re: Pregnancy Test Advised for Female Trauma Victims Prior to Radiation Exposure
Does anyone know if the doses described, and, more to the point, the ACOG's
"maximum limit", are fetal/embryo doses, or something else? The
implication of the first paragraph in the news article is that the primary
dose of concern, when considering the management of a pregnant patient, is
that to the mother.
It's difficult for me to believe that most health/medical physicists would
agree with that. E.g., one of the studies that is likely common in the
workups of trauma patients is cranial CT. One imagines that an entrance
exposure, or total imparted dose, to the *patient*, from such a procedure,
could result in a number that would sound very large, in the context of
pregnancy, but that the actual fetal dose would be very much lower (two
orders of magnitude?)
Hastily, I don my armor, and take up my shield
cja
At 12:43 AM 7/8/01 -0400, you wrote:
>Of possible interest to RadSafers...
>- Susan Gawarecki
>
>Pregnancy Test Advised for Female Trauma Victims Prior to Radiation
>Exposure
>
>WESTPORT, CT (Reuters Health) Jun 28 - Trauma patients in whom
>pregnancy status is not known are routinely exposed to doses of
>radiation exceeding the maximum limit of 5 rads established by the
>American College of Obstetrics and Gynecologists, according to
>physicians from the University of Maryland School of Medicine in
>Baltimore.
>
>Dr. Grant V. Bochicchio and associates found that, of 3976 women of
>reproductive age admitted to a trauma center between 1995 and 1999, 114
>were pregnant. Nine of the pregnancies were previously undiagnosed; in
>four cases, the patient was unable to tell the trauma team that she was
>pregnant.
>
>According to the investigators' report in the May issue of the Journal
>of the American College of Surgeons, a mean radiation dose of 4.3 rads
>was received by the patients with incidental pregnancy during their
>initial resuscitation. Cumulative radiation exposure was greater than 5
>rads in 85% of patients.
>
>There were 10 fetal deaths among those with incidental pregnancy, of
>which three were the result of elective abortion. These abortions were
>performed because of the mother's fear of an abnormal fetus resulting
>from the injury and the radiation exposure.
>
>Dr. Bochicchio and his colleagues suggest that female trauma victims of
>childbearing age should receive a quick urine pregnancy screen,
>routinely undergo abdominal and pelvic ultrasonography, and have an
>abdominal shield when undergoing radiologic evaluation.
>
>J Am Coll Surg 2001;192:566-569
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