Radiologic Evaluation

The use of diagnostic radiologic imaging in the emergency treatment of pregnant trauma patients adheres to the fundamental principles of trauma management. While the judicious acquisition of studies is indicated to minimize fetal exposure to the potential effects of ionizing radiation ( IabJe..246-1), no tests should be withheld if necessary for appropriate maternal evaluation and treatment. The principal concerns regarding radiation exposure in utero are the possibilities of childhood neoplasia, fetal loss, congenital malformations, and microcephaly.13 Thus, studies should be limited to those needed, as radiation exposure sequelae are cumulative. The greatest risk to fetal viability is within the first 2 weeks following conception, and the highest potential for malformation is during embryonic organogenesis from 2 to 8 weeks after conception.13 Adverse fetal effects due to radiation exposure are negligible from doses of less than 10 rad. The standard trauma plain radiographs, such as cervical spine, chest, and pelvis films, deliver significantly less than 1 rad each. 413 Fetal exposure can be further decreased by appropriate shielding of the maternal abdomen and pelvis during many studies.

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