From the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, 300 Community Dr, Manhasset, NY 11030 (J.M.); Department of Radiology, Division of Vascular and Interventional Radiology, Northwell Health, Manhasset, NY (J.K., C.Y.); Department of Radiology, Division of Vascular and Interventional Radiology, NYU Grossman School of Medicine, New York, NY (A.N.); and Department of Radiology and Radiologic Sciences, Division of Vascular and Interventional Radiology, Vanderbilt University School of Medicine, Nashville, Tenn (N.V.).
Radiographics. 2023 Aug;43(8):e230029. doi: 10.1148/rg.230029.
Interventional radiology (IR) plays a unique and often invaluable role in the care of pregnant patients. Special considerations regarding radiation exposure and medication choice must be taken into account when evaluating a pregnant patient for an interventional procedure. In addition, the physiologic changes that occur during pregnancy can pose special challenges for an interventionalist when treating this patient population and should be appropriately recognized. Still, the majority of standard IR procedures can be safely performed in the pregnant population, often with additional precautions and proper patient education about the risks, benefits, and alternatives. In many cases, interventional radiologists can provide lifesaving and fertility-preserving alternatives to more invasive surgical intervention. The authors summarize radiation exposure effects and guidelines and medication choice during pregnancy. The physiologic changes that occur during pregnancy are discussed, with specific interest in the pathologic consequences that can be treated with IR. The authors also describe a wide variety of minimally invasive image-guided procedures offered by IR in pregnant, peripartum, or postpartum patients. The areas where IR can help in the treatment of pregnant patients include venous access, biopsies, genitourinary and biliary interventions, venous thromboembolism treatments, ectopic pregnancy management, aneurysm intervention, and management of trauma patients. IR is also involved in management during the peripartum or postpartum periods, with roles in treatment of invasive placenta spectrum, postpartum hemorrhage after vaginal delivery, and postcesarean delivery complications. RSNA, 2023 Quiz questions for this article are available through the Online Learning Center.
介入放射学(IR)在孕妇的治疗中发挥着独特且往往非常宝贵的作用。在评估孕妇进行介入手术时,必须考虑到辐射暴露和药物选择的特殊考虑因素。此外,怀孕期间发生的生理变化会给介入治疗带来特殊挑战,应适当识别。尽管如此,大多数标准的 IR 程序可以在孕妇人群中安全进行,通常需要额外的预防措施和适当的患者教育,以了解风险、益处和替代方案。在许多情况下,介入放射科医生可以为更具侵入性的手术干预提供救生和保持生育力的替代方案。作者总结了怀孕期间的辐射暴露影响和指南以及药物选择。讨论了怀孕期间发生的生理变化,特别关注可以通过 IR 治疗的病理后果。作者还描述了 IR 在孕妇、围产期或产后患者中提供的各种微创影像引导程序。IR 可以帮助治疗孕妇的领域包括静脉通路、活检、泌尿生殖和胆道介入、静脉血栓栓塞治疗、宫外孕管理、动脉瘤介入和创伤患者的管理。IR 还参与围产期或产后的管理,在治疗侵袭性胎盘谱、阴道分娩后产后出血和剖宫产术后并发症方面发挥作用。RSNA,2023 本文的测验问题可通过在线学习中心获得。