THERAPEUTIC ABORTION ON ACCOUNT OF X-RAY EXAMINATION DURING PREGNANCY

Journal Article · Mon Jun 01 04:00:00 EDT 1959 · Danish Med. Bull.

OSTI ID:4634654

Hammer-Jacobsen, E

In Denmark in recent years, x-ray examination of pregnant women has in some instances been either the sole or a contributory indication for therapeutic abortion. The case histories are discussed of 11 pregnant women who had one or more abdominal x-ray examinations during the first 3 months of pregnancy. Therapeutic abortion was later performed in 8 cases while 3 went on to term. The calculated fetal doses in these cases ranged from 0.3 to 3.7 r. To calculate the dose in the uterus in relation to the rectal dose, measurements were made in a paraffin phantom and Mix D phantom blocks. It was found that the dose at a depth of 10 cm (uterus) is two or three times as large as at a depth of 15 cm (rectum), when using radiation of diagnostic quality. For the purpose of these calculations the fetal dose was assumed to be twice that of the rectum (anteroposterior projection). On the basis of examination of the aborted fetuses and the three children that were born, it was concluded that one of these children, whose development was abnormal, shouid have been aborted and that four of the induced abortions were unnecessary. The placenta had undergone fibrosis in the case of the abnormal child, who had received 3.7 r 50 days after conception. On the basis of these results and a survey of the literature the following rules are proposed relating to use of radiodiagnosis during the 1st 4 months of pregnancy: Fetal doses of less than approximates 1 r are presumed to cause no noticeable injury, and consequently provide no indication for therapeutic abortion. Fetal doses between l to 10 r are assumed, in some instances, to cause injuries taking the form of diseases, malformations, slow development, or reduced resistance, especially when irradiation occurs between the second and sixth week. Doses should be individually evaluated after measurements with the x-ray units used, and if these doses are reached, therapeutic abortion is advisable. Fetal doses above about 10 r are assumed to involve a great probability of fetal injury, and induction of abortion should therefore be the rule. During the last 5 months of pregnancy the fetus will withstand considerably higher doses, of the order of those occurring in pelvimetry. If abortion is performed, the fetus should always be microscopically examined. When birth follows irradiation of a fetus with doses exceeding about 1 r, the development of the child should be kept under observation. It is recommended that in fertile women, x-ray examination of the abdomen should be performed only during the first 10 days following regular menstruation. This rule should be introduced as a routine by all radiological departments, and radiologists. The physician referring the patient for x-ray examination should state the latest date of menstruation in the reference. If the possibility of pregnancy cannot be excluded, x-ray examination should be avoided or postponed until the last 5 months of pregnancy. Only vitally indicated examinations should be exempted from this rule. Each year in Denmark, it is calculated, about 30,000 abdominal x-ray examinations of women 15-39 yr old are carried out, and about 300 of these women are in their first month of pregnancy. (BBB)

• Research Organization: Rigshospitalet, Copenhagen
• NSA Number: NSA-17-038779
• OSTI ID: 4634654
• Journal Information: Danish Med. Bull., Journal Name: Danish Med. Bull. Vol. Vol: 6
• Country of Publication: Country unknown/Code not available
• Language: English

Related Subjects

BIOLOGY AND MEDICINE
DENMARK
EMBRYOS
FETUSES
MALFORMATIONS
MAN
MEASURED VALUES
MICROSCOPY
MOCKUP
PARAFFIN
PLACENTA
PREGNANCY
RADIATION DOSES
RADIATION INJURIES
RADIOGRAPHY
SEX
STANDARDS
TISSUES
UTERUS
X RADIATION