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委员会意见第 723 号:妊娠期和哺乳期诊断影像学检查指南。

Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation.

出版信息

Obstet Gynecol. 2017 Oct;130(4):e210-e216. doi: 10.1097/AOG.0000000000002355.

Abstract

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.

摘要

影像学检查在急性和慢性疾病的诊断评估中是重要的辅助手段。然而,对于孕妇和哺乳期妇女及其婴儿来说,这些影像学检查的安全性往往存在混淆,导致不必要地避免了有用的诊断性检查,或不必要地中断了母乳喂养。超声检查和磁共振成像不具有风险,是孕妇的影像学检查首选方法,但应谨慎使用,仅在预期能回答相关临床问题,或对患者有医疗获益时使用。除了少数情况外,通过 X 射线摄影、计算机断层扫描或核医学成像技术进行的放射性暴露的剂量远低于与胎儿损害相关的剂量。如果这些技术在超声检查或磁共振成像之外还需要进行,或者更便于诊断所关注的疾病,则不应拒绝为孕妇提供这些技术。在给予钆造影剂后不应中断母乳喂养。

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