What is the role of chest radiography in the evaluation of hypertensive disorders during pregnancy?

Updated: Jun 12, 2018
  • Author: Michael P Carson, MD; Chief Editor: Edward H Springel, MD, FACOG  more...
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Answer

Answer

Obtain chest radiographs to evaluate for pulmonary edema in the setting of dyspnea or hypoxia occurring in a woman with preeclampsia, as shown in the following image.

Noncardiogenic pulmonary edema in a patient with p Noncardiogenic pulmonary edema in a patient with preeclampsia. This is due to a capillary leak that can be a primary component of preeclampsia. The radiograph demonstrates a diffuse increase in lung markings without the cephalization or vascular redistribution that is seen in patients with pulmonary edema from systolic dysfunction. This patient had rapid clinical improvement after only 10 mg of intravenous furosemide.

The fetal ionizing radiation exposure of one maternal chest radiograph with abdominal shielding is only 0.001 rads. Although no dose of ionizing radiation is absolutely safe during pregnancy, a commonly held acceptable cumulative dose is 5 rads during pregnancy (approximately 5000 maternal chest radiographs could be performed before reaching this safety threshold).


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