Document Detail


A radiation perspective for treating loin pain in pregnancy by double-pigtail stents.
MedLine Citation:
PMID:  12460336     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To review the risks of placing double-pigtail stents during pregnancy in women presenting with loin pain associated with hydronephrosis. PATIENTS AND METHODS: A consecutive series of women presenting with loin pain and hydronephrosis in pregnancy were treated with double-pigtail ureteric stents. A flexible cystoscope was used to identify the ureteric orifice and to pass a guidewire into the renal pelvis under fluoroscopic guidance. Stents were placed using the exchange technique over a stiff guidewire. Procedures were carried out under none or limited sedoanalgesia. Screening times and radiation dose were recorded. Data were collected for the average uterine radiation dose from a variety of radiological procedures. Previous publications were reviewed to determine the lethal, teratogenic and carcinogenic risk to the developing fetus from radiation exposure. RESULTS: Seven patients referred with symptomatic hydronephrosis during pregnancy were treated. The screening time during placement was minimized. The mean (range) uterus (i.e. fetal) dose was 0.40 (0.03-0.79) mGy. Most radiological procedures involve uterine doses of < 20 mGy, far below the 100 mGy that may result in fetal damage during periods of maximum radiosensitivity. CONCLUSION: Minimized radiation exposure from a range of uroradiological procedures in pregnant women has limited fetal risk. The use of fluoroscopy for symptomatic hydronephrosis during pregnancy allows ureteric stents to be placed safely and reliably. The average excess risk to the fetus from this procedure is 1 in 43 000 of cancer induction and 1 in 100 000 of heritable disease, i.e. very small when compared with the natural incidence. Pregnancy should not exclude the use of appropriate diagnostic radiation exposure and urologists may conduct appropriate diagnostic and therapeutic procedures, taking care to limit X-ray exposure without fear of risk to the developing fetus.
Authors:
G O Hellawell; N C Cowan; S J Holt; S J Mutch
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  BJU international     Volume:  90     ISSN:  1464-4096     ISO Abbreviation:  BJU Int.     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-03     Completed Date:  2003-01-16     Revised Date:  2006-07-18    
Medline Journal Info:
Nlm Unique ID:  100886721     Medline TA:  BJU Int     Country:  England    
Other Details:
Languages:  eng     Pagination:  801-8     Citation Subset:  IM    
Affiliation:
Department of Urology, The Churchil Hospital, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Adult
Dose-Response Relationship, Radiation
Female
Fluoroscopy / adverse effects*
Gestational Age
Humans
Hydronephrosis / radiography*,  therapy
Pelvic Pain / radiography*,  surgery
Pregnancy
Pregnancy Complications / radiography*,  therapy
Prenatal Exposure Delayed Effects
Radiography, Interventional / adverse effects
Risk Factors
Stents*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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