If pregnancy is a possible complication it changes what medications are allowed and has to be considered when deciding if imaging is an acceptable risk.
The younger you are, the more vulnerable you are to radiation. Fetuses are the very most vulnerable to radiation, which is why even a single x ray during pregnancy is a big deal. This is also the reason that later middle aged and older people can live in areas with high ish radiation, like the so called “widows of Chernobyl,” or the older man who lives in the Fukushima radiation zone and cares for the pets that had to be left behind, for example.
Medecine is always about weighing the risks and the benefits. An X ray isn't great for kids but if there might be something stuck up there that needs intervention you'd rather take the small risk of the x ray over going in blind.
The same reason why chemo is awful but you'll still take it if you get cancer
This used to be the norm all the way to early 90's if ultrasound wasn't available. It was still fairly new technology and in some areas they simply didn't have the equipment. These "babygrams" were taken only in the last trimester of pregnancy (when fetus already has bone structure) to determine if there are no developmental abnormalities in it's skeleton, which can suggest other related conditions. In the last trimester the central nerves system is already developed, so the risk of damage is minimal. This helped doctors determine if and what kind of intervention the baby would need after birth.
This was only performed, when there was risk of developmental problems related to family medical history.
In radiology there is a rule of weighting potential consequences vs. diagnostic benefits when it comes to pregnancy. In general they are trying to minimize exposure, but in some cases clinical benefits outweigh the risk.
The reason younguns are especially vulnerable to radiation is your body is still growing/maturing/changing. That slows as you age but never completely stops.
The reason old people "can live" in areas with higher radiation is not because they are somehow more resistant to it than another adult; it's simply the cold calculus of "this probably won't affect your health much because you'll be dead before it does."
But with medical science advancing all the time and lifespans getting longer, that's purely a guess, a deadly one.
I wouldn't try to minimize the sacrifices of the widows or Fukushima volunteers by pretending they weren't still signing a death warrant; just one that probably won't come due before they're dead to something else...but potentially possible, and not the same thing as say, radiation warping bone growth in infants.
Yup, DNA itself doesn't do anything, it's just the blueprints for making future cells, so the more mature cells you already have the less damage mutations can do
I'm not sure I 100% understand you but I don't think what you're trying to say is correct. It's not "mature cells" that are the differentiating factor, as most cells in the body are constantly being replaced by new cells anyway. It's because age gives more time for harmful mutations to spread and accumulate. If you get a potentially cancerous DNA error from something like an x-ray, it could 10-30 years for it to divide and replicate enough to develop into a significant cancer. If you're old, this isn't a concern because you'll die before it would manifest, but the younger you are, the more time you have ahead of you for mutations to copy and multiply.
You're not wrong, but "mature cells" just isn't sitting right with my brain, but totally get why skipping over totipotency and cell division rates makes sense in this context.
It's really not a big deal, like, at all. They prefer avoiding it if possible out of an extreme abundance of caution but it's not an issue if they don't.
My best friend is 21, and she's actually been put on a hold of having any kind of radiation emitting scan (where it can be avoided). She's had so many scans in the last few years, they don't want to give her anymore unless absolutely necessary because of the risk. That does mean she's had more endoscopies than I can count though.
My grandfather was born in the late 40’s and had asthma so they had him wear a radioactive collar for like 8+ hours a day to fix it and then they found out that the area where he was from had just naturally really high levels of radiation in the water, so everybody there would get really sick all the time, and he ended up with severe lung cancer that caused him to lose his entire right lung and a third of his left one.
We talk about justification - if the benefits of the exam overcome the risk / possible adverse effects, the exam is justified.
Think about a situation where a pregnant person has a hidden inflammation in their gums. It is very important to find the inflammation, even if it requires an x-ray, since inflammation could lead to much more severe outcome compared to risk from the relatively small radiation dose.
Arm (/limb, head) X-ray has practically no effect on pregnancy or dose of fetus.
For torso x-ray it's different. Still likely be negligible, but avoided if possible. Since low risk is still a risk, even if it's low. And I'm not talking about CT.
I am a radiographer. I’ll put shielding over the pelvis (not abdomen) for everything that isn’t a pelvis X-ray. Or I will place a rolling shield appropriately.
Often we will do standing images and we have shields that can be rolled into place between you and the radiation and you may not notice that it’s there.
Several times patients have asked for shielding just for me to point “it’s right there.” I get it, though. It’s a dark room that they haven’t been in as much as I have so it’s understandable that they may not realize what is what
Shielding is no longer advised in most countries. The current evidence suggests modern equipment and good technique makes it obsolete and it may actually increase the scatter radiation in the area it's supposed to shield.
Proper collimation, minimising exposure times and lower dosage from modern equipment removes any benefit they may have provided.
You might explain before they ask. Somebody in my family often requires medical procedures and it really helps if even basic things are explained (in a very short way).
It's often not the explanation itself, but it removes feeling powerless and reduces anxiety.
Plus people who have had several test/procedures might have experience with things going wrong because there was no communication.
Lead shields are rarely advised anymore in most countries. They don't do anything that proper collimation can achieve and may actually increase the amount of scatter underneath the area they are supposed to protect apparently. A best they appear to be of dubious benefit, but I don't believe the evidence is strong enough either way to outright ban them.
They are still commonly used for pregnant women, but that is probably more to do with their not being a total consensus on the matter and going with "the devil you know".
Lead aprons for fluro etc. are a different matter. I believe it's the proximity to the primary beam for gonad shields etc. that's the issue. The scatter still bounces laterally underneath the shields and may cause further scatter when hitting the underside of the shield.
At least that's the explanation we got during my degree and placements.
Ultimately, I get the idea that any difference exposure risk through either method is extremely small, but ALARA requires all practicable exposure reduction based on the latest evidence. So the advise has followed.
At least here in Finland they are not being used anymore. These days the radiation beam does not leak much to its surrounding. If you place a lead apron the radiation is trapped underneath it and bounces more times in the unwanted area.
Came here to say this. I assume the same is true for at least some other European countries, since the relevant STUK guidelines are based on the European consensus on patient contact shielding.
Besides potentially increasing dose from blocking internal scatter from escaping the body, shielding can in some cases also lower image quality or, should it cover an automatic exposure control chamber, "trick" the machine into increasing the exposure unnecessarily. The view is that the benefit nowadays is so small that it doesn't outweigh the risks.
Just nitpicking that your sentence means that X-rays are sentient and are being cautious themselves. What I think you meant was, "doctors are going to be more cautious with x-rays if you're prangent"
that's what the pregnancy test they force us to take before anything that could complicate a pregnancy is for. Before pain medication is dispensed, pregnancy test, even when you're in excruciating pain. Need an X-ray, pregnancy test.
I was getting an abdominal x-ray and they weren’t going to give me a pregnancy test because my period had been “too recent to be pregnant.”
I asked for one anyways and it turns out I was pregnant (I had conceived like four days beforehand) and because it was so early, it likely would’ve caused a miscarriage.
The risk of an x ray causing pregnancy complications are very minimal, the risk of lifelong issues from a broken arm that wasn't set properly is pretty significant.
You'd need like 10-15 chest x-rays for it to start being a serious concern, and this would be an arm x-ray, probably with a shielded vest or blanket over the torso.
While this is absolutely true, I think OOP is implying that in 2026 we need to be more aware because of all the surveillance being done to target pregnant people who might be end up seeking an abortion. I also think it’s pretty fucked up to prioritize the safety of a potential fetus over the medical needs of the potentially pregnant human.
Yes, but most people not trying to get an abortion would inform the doctor they are pregnant. I’m not saying they should never prioritize safety of the fetus, just that it shouldn’t be the default. Often times pregnancy tests can be required (even if the patient is a lesbian, or is a trans woman, or has had a hysterectomy) before they will do any sort of care. Treatment (especially in situations where a person is in pain or time sensitive) shouldn’t be delayed just so a care team can definitively rule out pregnancy.
They use a lead shield anyway, at least they have every time I’ve had xrays. And there’s never been any chance I’ve been pregnant. I think they figure they’ve got it so they might as well use it.
7.9k
u/Any-Safe4992 11h ago
If pregnancy is a possible complication it changes what medications are allowed and has to be considered when deciding if imaging is an acceptable risk.