第723号委员会意见摘要:孕期及哺乳期诊断性影像学检查指南
Committee Opinion No. 723 Summary: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.
出版信息
Obstet Gynecol. 2017 Oct;130(4):933-934. doi: 10.1097/AOG.0000000000002350.
Imaging studies are important adjuncts in the diagnostic evaluation of acute and chronic conditions. However, confusion about the safety of these modalities for pregnant and lactating women and their infants often results in unnecessary avoidance of useful diagnostic tests or the unnecessary interruption of breastfeeding. Ultrasonography and magnetic resonance imaging are not associated with risk and are the imaging techniques of choice for the pregnant patient, but they should be used prudently and only when use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient. With few exceptions, radiation exposure through radiography, computed tomography scan, or nuclear medicine imaging techniques is at a dose much lower than the exposure associated with fetal harm. If these techniques are necessary in addition to ultrasonography or magnetic resonance imaging or are more readily available for the diagnosis in question, they should not be withheld from a pregnant patient. Breastfeeding should not be interrupted after gadolinium administration.
影像学检查在急慢性疾病的诊断评估中是重要的辅助手段。然而,对于怀孕和哺乳期妇女及其婴儿而言,这些检查方式的安全性存在混淆,这常常导致不必要地避免使用有用的诊断测试,或者不必要地中断母乳喂养。超声检查和磁共振成像不存在风险,是孕妇的首选成像技术,但应谨慎使用,且仅在预期使用能回答相关临床问题或为患者带来医疗益处时使用。除少数例外情况,通过X线摄影、计算机断层扫描或核医学成像技术的辐射暴露剂量远低于与胎儿伤害相关的暴露剂量。如果除超声检查或磁共振成像外还需要这些技术,或者它们更便于对所讨论的疾病进行诊断,那么不应不给孕妇使用这些技术。使用钆剂后不应中断母乳喂养。