MRI in pregnancy: Indications and practical considerations

@article{Mervak2019MRIIP,
  title={MRI in pregnancy: Indications and practical considerations},
  author={Benjamin M. Mervak and Ersan Altun and Katrina A McGinty and W. Brian Hyslop and R C Semelka and Lauren M B Burke},
  journal={Journal of Magnetic Resonance Imaging},
  year={2019},
  volume={49}
}
There is a constantly evolving knowledgebase regarding the safety of MRI in pregnant patients, as well as the safety of gadolinium administration, given potential fetal risks. This review provides an overview of national and international recommendations for patient screening and safety by trimester, evaluates the most recent literature regarding administration of gadolinium in pregnant patients, and discusses technical requirements when imaging pregnant patients. A protocol for imaging… 
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31 Citations

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References

SHOWING 1-10 OF 58 REFERENCES
Techniques, terminology, and indications for MRI in pregnancy.
TLDR
A review of current evidence supports the following indications for fetal MRI: suspected central nervous system anomalies, neck and oropharyngeal masses, diaphragmatic hernia, abdominal masses or bowel pathology not fully characterized by ultrasonography, and suspected fetal infection.
Safety of Contrast Material Use During Pregnancy and Lactation.
Imaging of pregnant and lactating patients: part 2, evidence-based review and recommendations.
TLDR
Diagnostic imaging should be performed during pregnancy only with an understanding of the maternal and fetal risks and benefits, the comparative advantages of different modalities, and the unique anatomic and physiologic issues associated with pregnancy.
MR safety issues particular to women.
Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation.
TLDR
The use of iodinated contrast agents is generally safe during pregnancy; nevertheless, these agents should be used with caution due to the risk of fetal hypothyroidism and should be administered only when the clinical situation clearly requires doing so.
Acute abdominal and pelvic pain in pregnancy: ESUR recommendations
TLDR
New guidelines based on the current literature and on the accumulated clinico-radiological experience of the European Society of Urogenital Radiology (ESUR) working group are proposed for imaging these suspected conditions.
Approach to the acute abdomen in pregnancy.
Acute Abdomen in Pregnancy
  • P. Glanc, C. Maxwell
  • Medicine
    Journal of ultrasound in medicine : official journal of the American Institute of Ultrasound in Medicine
  • 2010
TLDR
The role of sonography in evaluation of acute abdomen during pregnancy is reviewed and sonographic findings of various maternal complications that can present with acute abdominal pain in pregnant patients are shown.
MR imaging of maternal diseases of the abdomen and pelvis during pregnancy and the immediate postpartum period.
TLDR
Until more conclusive safety data become available, MR imaging should be reserved for cases in which results of ultrasonography are inconclusive and patient care depends on further imaging.
MRI of acute abdominal and pelvic pain in pregnant patients.
TLDR
The intrinsic safety of MRI and its ability to accurately show abdominal and pelvic disease in pregnant patients make it highly useful in the evaluation of these patients.
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