1/6. Treatment of unstable fractures of the pelvic ring in pregnancy.Unstable fractures of the posterior pelvic ring during pregnancy are rare. pregnancy increases the high demands on the therapy of these types of fractures. The aim of the therapeutic strategy in such a situation is a good functional outcome of the mother without influencing the fetal health. Some osteosynthetic techniques result in good functional outcomes, but they are associated with high amounts of ionizing radiation. We report the case of a pregnant woman who sustained a vertical unstable fracture of the posterior pelvic ring as a result of a traffic accident. The fracture was treated surgically by open reduction and internal fixation with two transiliac reconstruction plates with minimal radiographic exposure to the fetus. One year later, a good functional result concerning the mother was shown. The child was healthy without any signs of prenatal impairment. Surgical treatment of an unstable fracture of the pelvic ring during pregnancy is possible with a justifiable risk to the mother and the child. Consideration of the expected fetal radiation exposure in the course of the therapy is particularly recommended. Using minimal doses of ionizing radiation, the described method results in a good clinical outcome of the mother while simultaneously reducing the radiation exposure of the fetus to an acceptable level.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/6. Uterine radiation dose from open sources: the potential for underestimation.The evaluation of the risk of radiation damage to the unborn child as the result of the administration of radionuclides remains a subject for discussion (Mountford 1989). Lack of information concerning the biodistribution of radiopharmaceuticals in the early stages of pregnancy, before organogenesis has occurred, has greatly restricted the objective assessment of fetal doses. Recent observations on the biodistribution of a therapeutic dose of sodium iodide 131 in a patient with an unsuspected early pregnancy lead us to suspect that current dose estimates with respect to uterine exposure (ARSAC 1988) may seriously underestimate the actual exposure of the developing fetus.- - - - - - - - - - ranking = 0.33333333333333keywords = pregnancy (Clic here for more details about this article) |
3/6. The effect of embryonic and fetal exposure to x-ray, microwaves, and ultrasound: counseling the pregnant and nonpregnant patient about these risks.The term radiation evokes emotional responses both from lay persons and from professionals. Many spokespersons are unfamiliar with radiation biology or the quantitative nature of the risks. Frequently, microwave, ultrasound, and ionizing radiation risks are confused. Although it is impossible to prove no risk for any environmental hazard, it appears that exposure to microwave radiation below the maximal permissible levels present no measurable risk to the embryo. Ultrasound exposure from diagnostic ultrasonographic-imaging equipment also is quite innocuous. It is true that continued surveillance and research into potential risks of these low-level exposures should continue; however, at present ultrasound not only improves obstetric care, but also reduces the necessity of diagnostic x-ray procedures. In the field of ionizing radiation, we have a better comprehension of the biologic effects and the quantitative maximum risks than for any other environmental hazard. Although the animal and human data support the conclusion that no increases in the incidence of gross congenital malformations, IUGR, or abortion will occur with exposures less than 5 rad, that does not mean that there are definitely no risks to the embryo exposed to lower doses of radiation. Whether there exists a linear or exponential dose-response relationship or a threshold exposure for genetic, carcinogenic, cell-depleting, and life-shortening effects has not been determined. In establishing maximum permissible levels for the embryo at low exposures, refer to tables 4, 5, 6, 8, and 9. It is obvious that the risks of 1-rad (.10Gy) or 5-rad (.05Gy) acute exposure are far below the spontaneous risks of the developing embryo because 15% of human embryos abort, 2.7% to 3.0% of human embryos have major malformations, 4% have intrauterine growth retardation, and 8% to 10% have early- or late-stage onset genetic disease. The maximal risk attributed to a 1-rad exposure, approximately 0.003%, is thousands of times smaller than the spontaneous risks of malformations, abortion, or genetic disease. Thus, the present maximal permissible occupational exposures of 0.5 rem for pregnant women (see Table 10) and 5 rem for medical exposure, are extremely conservative. Medically indicated diagnostic roentgenograms are appropriate for pregnant women, and there is no medical justification for terminating a pregnancy in women exposed to 5 rad or less because of a radiation exposure.(ABSTRACT TRUNCATED AT 400 WORDS)- - - - - - - - - - ranking = 0.16666666666667keywords = pregnancy (Clic here for more details about this article) |
4/6. Inadvertently performed hysterosalpingography during early pregnancy.A review of 6,225 hysterosalpingographies disclosed four cases of inadvertently performed examinations during early pregnancy. These radiologic misadventures were in three cases performed because of oligomenorrhoea and in one case because of a misjudged decidual bleeding. The radiologic findings and the outcome of these pregnancies are presented. Precautions to avoid this radiographic error are discussed.- - - - - - - - - - ranking = 0.83333333333333keywords = pregnancy (Clic here for more details about this article) |
5/6. microcephaly, mental retardation and chromosomal aberrations in a girl following radiation therapy during late fetal life.A human foetus was heavily irradiated in the thirtieth to the thirty-third week due to carcinoma of the uterine cervix of the mother. Irradiation after 20 weeks of pregnancy is thought not to produce severe abnormalities. However, the child showed microcephaly, mental retardation, stunted growth, microphthalmus, retinal degeneration, cataract and defective dentition. Cytogenetically the frequencies of both chromatid and chromosome breaks were increased.- - - - - - - - - - ranking = 0.16666666666667keywords = pregnancy (Clic here for more details about this article) |
6/6. radiotherapy for Hodgkin's disease in pregnancy.Hodgkin's disease diagnosed during pregnancy poses a dilemma as there are risks of abortion and fetal malformation with the use of radiotherapy and chemotherapy. A patient with Hodgkin's disease during pregnancy treated with radiotherapy is presented.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |