Pregnancy, which in obstetric practice is called gestation, is a crucial period for every woman.
It is necessary to take it seriously, because this stage radically changes the life of the future mother, dividing it into “can” and “not”. If a pregnant woman is healthy, then her baby will be born healthy, so from the very beginning of her pregnancy she should undergo a whole series of studies called prenatal screening.
But there are diagnostic procedures that cannot be performed, or strict limitations are imposed on their implementation. First of all, it concerns manipulations during which the body is irradiated - x-ray measures. However, what to do if the patient first took an x-ray, and only then found out about the pregnancy? Will this affect the health of the unborn child, and how to be if there is an urgent need for the passage of the WG during gestation?
Mechanism of action
X-rays are not completely safe for a healthy person, and this is a well-known fact. A pregnant woman, like the unborn child himself, is very vulnerable to any negative effects, so such a diagnosis may adversely affect the formation of the fetus.
How does x-ray irradiation work? When it interacts with the tissues of the body, the process of ionization of water occurs, which causes the formation of active radicals. The latter, in turn, violate cell division, which provokes chromosomal abnormalities. As a result, the cells either die, or mutate, turning into cancer or genetically deficient.
Under the influence of X-rays, a fetus can form tumors, develop various malformations, or develop genetically determined abnormalities. Extremely dangerous is the impact on the body of a pregnant woman, and, consequently, of the unborn child, rays, which in their power exceed the indicator of 1 m3. Under this influence, there are 2 possible options for the development of further events:
- miscarriage occurs in the early stages;
- Full-term baby is born seriously ill.
Similarly, the radiation elements that “absorbed” into the body of pregnant women after the bombing of Hiroshima and Nagasaki by the US forces also affected. At that time, about 20% of women gave birth to children with all kinds of disabilities and serious illnesses. Since the principle of action of X-rays on the body is based on the use of ionizing radiation, the conduct of this diagnostic procedure during gestation should be justified.
Can I do x-rays during pregnancy?
Radiography involves exposure to ionizing radiation, which adversely affects the development of the embryo, and then the fetus. Therefore, WG can rightly be called a dangerous diagnostic procedure for a pregnant woman. Moreover, in certain periods of fetal development, it may even be dangerous.
A brief conclusion. Based on all of the above, roentgenography is not recommended for expectant mothers. However, there is no strict prohibition, therefore, in case of special need, the procedure can be assigned to pregnant women.
Such a study can only be carried out as a last resort, especially since today there are safer diagnostic methods for future mothers. Radiography is appointed only if it is necessary for an accurate diagnosis and further development of the treatment regimen.
In addition, the implementation of such manipulation at different stages of pregnancy is strictly regulated by regulatory medical documents. This approach helps to significantly reduce the risks to the fetus, and reduce the negative impact on it of ionizing radiation.
How often can x-rays be taken during pregnancy?
The best option for pregnant women, in view of the above reasons, is a complete rejection of diagnostic procedures that are based on the exposure of the body. This concerns both classical radiography and computed tomography, with or without contrast. However, unfortunately, it is not always possible to avoid the need for the future mother to undergo such research.
In medical practice there is a strict rule according to which the radiation load on the fetus is safe only if it is no more than 0.3 m3v. This roughly corresponds to the passage of 1 x-ray examination of the lungs.
If the level of radiation exceeds this indicator (for example, 30 m3v, which corresponds to repeated conduction of the RG), then the doctors advise to terminate the pregnancy. This situation is already potentially dangerous for the fetus.
But it cannot be said that x-ray during pregnancy is an extremely dangerous procedure. A woman should relate to the need to perform such manipulation quite calmly. First, a diagnostic study is carried out exclusively on doctor's prescription, and secondly, there are certain measures that will help minimize the negative impact of ionizing effects on the body of the unborn child.
In what cases the rejection of X-rays is undesirable?
There are situations when radiography during pregnancy is not only allowed, but also extremely necessary. Refusal of the procedure can lead to serious consequences, especially if we are talking about pathologies that are fraught with serious complications. The latter will ultimately affect not only maternal, but also children's health.
However, it should be borne in mind that the closer the examination area is to the fetus, the more negative the effect of X-rays on it will be. For example, WG for limb fractures is less dangerous than when you need to study the spine or pelvis.
In case of fractures of the arms and legs, doctors resort to protective measures - shielding. It involves the use of special lead aprons. They are placed on the chest, abdomen and pelvis of a pregnant woman, and prevent the penetration of ionizing radiation through the skin to the uterus and fetus.
X-ray diagnostics for pathologies of teeth, jaws, and nasal sinuses is also considered harmless, since the effect of X-ray exposure on the body of the expectant mother is insignificant. In addition, such radiation is clearly focused, and in this case, a full screening is also used as a preventive and protective measure.
Modern X-ray machines help to minimize the risks of negative consequences for the fetus, since they give rays clearly focused and directed. And this concerns not only the "classical" X-ray, but also the equipment for computed tomography.
Expectant mothers are strictly forbidden to help children or relatives in carrying out this diagnostic procedure. If a pregnant woman works as a radiologist, then before maternity leave she is urgently transferred to another, safer, medical work.
The effects of X-rays during early pregnancy
The impact of X-rays on the body of the unborn child depends on the duration of pregnancy. However, according to the results of numerous studies, it can be judged that the earlier the fetus (more precisely, the embryo) was exposed to such irradiation, the more severe and severe the lesions will be. They, in turn, will entail serious consequences for the health of the future baby.
The most critical for the fetus is the period up to 9 weeks of pregnancy. If an x-ray examination is carried out before this date, the radiation dose can be extremely dangerous. Starting from the 9th week of the gestational period, the risks for the unborn child gradually decrease, but do not completely disappear.
The embryonic period lasts from 1 to 8 weeks of pregnancy. This is the most crucial and important period, since in its length, the founding and gradual formation of vital organs and systems of the future child takes place.
In the first week of gestation, the process of fertilization of the egg and its subsequent crushing occur. Due to this process, a multicellular structure is formed, after which the embryo gradually begins to move into the uterine cavity. Having reached the goal, the ovum is implanted in the wall of the reproductive organ, and at this time we can speak directly about the occurrence of pregnancy.
Next, cell division into germ layers and tissue beginnings occurs. From 4th to 8th week, the formation of key, leading, vital systems - nervous, musculoskeletal, and others takes place. At this time, the skeleton and limbs are formed.
By the end of week 8, the digestive tract and respiratory system are formed. During this period, exposure to X-ray exposure, as well as many other teratogenic factors, is considered the most critical and dangerous. Such an effect can lead to intrauterine death of the embryo, followed by miscarriage.
If a similar scenario of development of events for a pregnant woman can be avoided, then it is likely that the child will be born with serious defects of the nervous system and many internal organs. They may be incompatible with life, or lead to severe disability of the child. In connection with such consequences, radiography, especially in the pelvic or back area, can be carried out in exceptional, life-threatening cases.
The influence of X-rays on the fetus after the 9th week
From the 9th week of pregnancy the fetal period begins. Although the effect of X-rays at this time is not critical, it is still not considered safe. For this reason, if possible, radiography is delayed until the time of delivery. If this is not possible, it is performed when it is needed.
Organs and tissues of the fetus at this time already formed, so the likelihood of malformations is significantly reduced. But it is not completely excluded, therefore it is impossible to conduct such a study without good reason.
Uncontrolled or too frequent performance of WG during pregnancy can lead to the development of neuropsychiatric abnormalities. In parallel with this, the risk of oncological processes, which may not be detected at the very beginning, increases. In addition, the negative effects of WG during pregnancy can occur in a child after many years.
What can replace the x-ray during pregnancy
Doctors, if possible, try to avoid the appointment of radiography to pregnant patients. In addition, many women are simply afraid to agree to such a procedure, and their concerns can not be called unfounded. For this reason, doctors are trying to replace RG with safer studies:
- Ultrasound. Ultrasound is completely safe for the fetus, so this diagnosis can be carried out at any stage of pregnancy. It is recommended for diseases of the pelvic organs, abdominal cavity, joints and muscles, lymph nodes, and thyroid gland.
- MRI The procedure is based on the use of a magnetic field, which does not have a destructive effect on the fetal DNA. Thus, cell mutation in the unborn child’s body does not occur. But, despite the fact that the negative effect of MRI on the fetus was not recorded, it is not recommended to perform in the first trimester of pregnancy.
- Visiography. This is a kind of X-ray, but such a procedure is carried out using a supernovae with a sensitive sensor. Due to this, it is possible to significantly reduce the intensity of harmful radiation. Typically, such manipulation is performed in dental practice to assess the condition of the crown or the roots of the teeth.
A pregnant woman must remember that the following are potentially dangerous to the health of her unborn child:
- computed tomography;
- isotope scan.
These procedures are based on intensive irradiation, therefore they are dangerous during pregnancy at any time. If such diagnostic techniques were used at the early stage of gestation, the gynecologist is entitled to recommend an abortion.
Can I do x-ray when planning pregnancy?
When planning a pregnancy, WG is not contraindicated, since ionizing radiation cannot damage an unfertilized egg. Even after several procedures with the use of X-ray equipment, a woman has the opportunity to conceive and give birth to a perfectly healthy child.
Moreover, doctors recommend that patients planning a pregnancy, before becoming pregnant, undergo a comprehensive and comprehensive examination. It should include fluorography or radiography, CT of the pelvis (with problems with conception), ultrasound, etc. Such a responsible approach to prenatal diagnosis helps to identify hidden pathologies from which women often suffer, especially in the early gestational period.
When planning a pregnancy, some women have to take hormonal drugs that suppress the immune system. This can also cause frequent morbidity during gestation. If a woman passes a comprehensive examination in a timely manner, including the procedures described above, the doctor will be able to identify the prerequisites for the development of certain pathologies, and prescribe a therapy that will help get rid of them before they can harm the future baby.