Friday, April 27, 2012

MiM Mailbag: Radiation during pregnancy

Hello,

I came across your blog entitled "Radiating yourself in Pregnancy." I am an interventional cardiologist and normally spend 2-4 days/week in the cath lab. I am 6 weeks pregnant and am a little nervous to be in the lab so often. I know of some other colleagues who spent a lot of time in the cath lab during their pregnancy and everything seemed to go ok. Their babies seem fine. I have a special badge and a maternity apron to wear under my lead and I have cut back to 1-2days/week. Do you think this is enough? I know there is no real answer to this question just looking for some stories to make me feel better:). I see there is a cardiologist among you. Just wondering if there are any physicians out there who have to be in the radiation for their job and did ok with pregnancy. Thanks!

A

6 comments:

  1. Hi A,

    I am actually a radiochemist (handle 50-100 mCi radioactive material for several hours, 5 days a week synthesizing novel PET imaging agents) and as I understand it, as long as you take proper precautions (staying under the ALARA limit, wearing the lead apron, etc.) there has been no causal link established between working with radioactive materials (safely) and adverse pregnancy outcomes.

    That being said, there are always accidents that can occur - I know of at least two accidental needle sticks, one with 89Zr, one with 18F, both in the multiple mCi range. At the end of the day, the decision is yours to make after weighing the risks - depending on your state, your employer is legally obligated to allow you to do equal work elsewhere (for equal pay) until the end of your pregnancy.

    From my perspective, it sounds like you are doing all the right things and should be fine. It's funny to see this come up, I think about it a lot. If I were to get pregnant (my husband and I are NOT trying at the moment) I will also try to limit my exposure to something less than what I currently do. However, I worry more about what the radiation exposure would have done to my oocytes than what the radiation exposure would do to the fetus.

    In short - it seems like you are taking all the proper precautions, and, as stated above, there has NOT been a causal link between safe radiation handling and adverse pregnancy outcomes.

    Congratulations!

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  2. I'm the one who wrote that post. I don't know if you realized but the cardiologist actually wrote a post following mine, sort of a rebuttal. You will probably find it reassuring:

    http://www.mothersinmedicine.com/2011/05/pregnant-in-cath-lab.html

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  3. Thanks for the helpful post, anon!

    I often think about this, too, and I agree, I worry more about my oocytes than fetus.

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  4. It is possible to get a digital badge that will read daily exposure. EPs actually get more radiation I think due to difficulty shielding with neck access. My fetal badge was always zero, cathing 3 half days a week. Pushing the table without core strength was the hardest part. Have someone pan for you. Nothing will take away anxiety fully except maybe frequent scans with echo probe. Good luck. Congrats.

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  5. It is possible to get a digital badge that will read daily exposure. EPs actually get more radiation I think due to difficulty shielding with neck access. My fetal badge was always zero, cathing 3 half days a week. Pushing the table without core strength was the hardest part. Have someone pan for you. Nothing will take away anxiety fully except maybe frequent scans with echo probe. Good luck. Congrats.

    ReplyDelete
  6. Thanks for bringing up this thread. Am looking to pursue a career in advanced endoscopy, and since there are no female advanced endoscopists in a 200 mile radius, really appreciated going back to the archive and reading about it- particularly from the women in the cath lab.

    ReplyDelete

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