Division of Vascular Surgery, Brigham and Women's Hospital, Boston, MA 02189, USA.
J Vasc Surg. 2012 Mar;55(3):862-868.e2. doi: 10.1016/j.jvs.2011.11.045. Epub 2012 Jan 24.
The evolution of endovascular surgery has increased the vascular surgeon's exposure to radiation, raising concern for female vascular trainees and staff of childbearing years. We developed surveys for female trainees, established vascular surgeons, and program directors in vascular surgery to determine current practices with respect to pregnancy and radiation exposure guidelines.
Two surveys were conducted to evaluate radiation exposure during pregnancy. A survey of the members of the Association of Program Directors in Vascular Surgery was conducted in an attempt to gather information about existing program and institutional radiation policies and assess the need for standard guidelines. A second survey was given to women in vascular surgery in an effort to obtain opinions among concerned groups regarding establishment of a policy from women who were exposed to radiation during and after completion of vascular training.
Fifty-three of 181 female vascular surgeons (29% response rate) responded to the survey, with the majority (53% [28/53]) pregnant during training or practice. Though 68% of trainees and 82% of faculty performed endovascular procedures during pregnancy, only 42% of trainees and 50% of faculty wore a fetal badge. One trainee (3.7%) had complications during pregnancy that necessitated cessation of fluoroscopic procedures or limiting call. There were four practicing surgeons who had complications during their pregnancy. Of these, one was hospitalized with fetal decelerations secondary to excessive on-call obligations with double leading and heavy endovascular call coverage. The majority of women (>60%) felt supported by the program and that they were treated fairly. Over 90% of female trainees and faculty felt that establishment of guidelines for radiation safety for all vascular surgeons would be beneficial. Many (77%) felt that a policy would aid in the recruitment of talented women into the field. Thirty-two of 99 Association of Program Directors in Vascular Surgery program directors responded to the survey. Of the 32 program directors that responded (32% response rate), 75% would allow the pregnant trainee flexibility in rotation schedule. Finally, 75% of program directors support development of a national policy, and 81% would incorporate one into their program.
There is compelling interest to establish radiation safety guidelines for the pregnant trainee or vascular surgeon. Consideration should be given at the Society leadership level to develop and support radiation safety guidelines for all vascular surgeons.
血管外科学的发展增加了血管外科医生的辐射暴露，这引起了对处于生育年龄的女性血管受训者和工作人员的关注。我们为女性受训者、已确立的血管外科医生和血管外科学术项目主任制定了有关妊娠和辐射暴露指南的调查问卷，以确定当前的实践情况。
我们进行了两项调查，以评估妊娠期间的辐射暴露情况。一项针对血管外科学术项目主任协会成员的调查旨在收集有关现有项目和机构辐射政策的信息，并评估制定标准指南的必要性。第二项调查针对血管外科领域的女性，旨在从在血管培训期间和之后接触过辐射的女性中获得有关制定政策的意见。
181 名女性血管外科医生中有 53 名（29%的回复率）对调查做出了回应，其中大多数（53%[28/53]）在培训或执业期间怀孕。尽管 68%的受训者和 82%的教职员工在妊娠期间进行了血管内手术，但只有 42%的受训者和 50%的教职员工佩戴了胎儿徽章。一名受训者（3.7%）在妊娠期间出现并发症，需要停止荧光透视检查或限制值班。有四名执业外科医生在怀孕期间出现并发症。其中一名因双重领导和繁重的血管内手术值班，需要大量值班而导致胎儿减速，住院治疗。大多数女性（>60%）感到得到了项目的支持，并且受到了公平对待。超过 90%的女性受训者和教职员工认为为所有血管外科医生制定辐射安全指南将是有益的。许多人（77%）认为政策将有助于吸引有才华的女性进入该领域。99 名血管外科学术项目主任协会的项目主任中有 32 名对调查做出了回应。在做出回应的 32 名项目主任中（32%的回复率），75%的人会允许怀孕的受训者灵活安排轮班时间表。最后，75%的项目主任支持制定国家政策，81%的项目主任将其纳入项目。
有强烈的兴趣为怀孕的受训者或血管外科医生制定辐射安全指南。应在学会领导层考虑制定和支持所有血管外科医生的辐射安全指南。
