In the diagnosis of different pathologies in pregnant women, the use of ionizing radiation in favor of image techniques such as ultrasound (ultrasound) or magnetic resonance should be avoided, according to specialists of the Spanish Society of Medical Radiology (SERAM) such as Dr. Mari Luz Parra, General Secretary of the SERAM and …
In it Diagnosis of different pathologies in pregnant womenthe use of ionizing radiation In favor of Image techniques such as ultrasound (ultrasound) or magnetic resonanceaccording to specialists from the Spanish Society of Medical Radiology (SERAM) Like Dra. Mari Luz Parra, General Secretary of the Seram and speaker at the SERAM-ARRS course on “Image of Women”which will take place in the La Paz University Hospital May 29 and 30 in Madrid with a presentation on “venous thromboembolic disease (ETEV) and pregnancy.”
The ETEV is one of the main causes of maternal morbidity and mortality during pregnancy and up to 6 weeks postpartum. The ETEV rate is calculated in 1.72/ 1,000 births, the deep venous thrombosis (TVP) with a similar distribution in each quarter being more frequent. Pulmonary embolisms (EP) occur more frequently in the puerperium.
“The pregnancy itself produces a state of hypercoagulability with increased procoagulant factors and decreased physiological anticoagulant factors. There is also compression of the pelvic veins by the gravid uterus and slow venous flow. Hence the risk is 5 times higher and 60 times greater in the first three months postpartum with respect to non -pregnant women”says Dr. Parra. The incidence varies between 1.2/1,000 during pregnancy and increases to 4.2/1,000 during the puerperium.
Risks that significantly increase the risk of ETEV during pregnancy:
- Age> 35 years
- The multiparity (> 2 children)
- Obesity before or at the beginning of pregnancy
- Prolonged rest, sedentary lifestyle
- Smoking
- The presence of great varicose veins
- ETEV’s personal or family history
- Congenital or acquired alterations of coagulation
- Antiphospholipid syndrome
“In addition to the predisposing factors described, the damage of the vessels linked to childbirth or caesarean section is added. Hence 40-60% of the pulmonary embolisms (EP) occur in the puerperium”, Specifies Dr. Parra.
The Radiologyespecially with studies such as Doppler ultrasound, pulmonary angiotc or gammography allows you to confirm or rule out the diagnosis of deep venous thrombosis (TVP) and pulmonary embolisms (EP). The treatment of the ETEV is anticoagulation, but unconflicting unconfirmation entails risks for both the mother and the fetus.
According to Dr. Parra “In case of dyspnea, chest pain, tachycardia, image tests can diagnose other pathologies such as pneumonia, pulmonary edema, etc. avoiding erroneous diagnoses. Initially, doppler ultrasound of the legs is performed to discard thrombosis. In case of pulmonary embolism, it begins with a thorax radiography to discard other diseases such as pneumonia, edema pulmonary or pneumothorax..
Without a doubt, an accurate radiological diagnosis Avoid exposing the patient and the baby to unnecessary medicines.
Protocols are optimized to reduce dose
In pathologies such as EP or in polytrauma where TC is needed, protocols are optimized to reduce the dose, not currently using contact shields (breast protectors or abdominal streams) by European consensus.
“Both pregnant women, obstetrician and petitioner urgenciologists of the tests with ionizing radiation, and the responsible radiologist, must sign the informed consent. Subsequently the radiophysical service issues a dosimetric file that remains in electronic history,”explains Dr. Parra.
It is important to emphasize that in Radiology is applied “Alara beginning”: The diagnosis should be obtained with the lowest possible radiation dose for the fetus and the pregnant woman.
Related news :