No Risk From Radiation for Pregnant Interventionalists

December 08, 2010

December 8, 2010 (Rochester, Minnesota) — Women of childbearing age should not be deterred from pursuing a career in interventional cardiology because of concerns about radiation exposure, says the Women in Innovations group of cardiologists [1].

"Current data do not suggest a significant increased risk to the fetus of pregnant women in the cardiac catheterization laboratory and thus do not justify precluding pregnant physicians from performing procedures," say Dr Patricia JM Best (Mayo Clinic, Rochester, MN) and colleagues in their paper, a consensus document endorsed by the Society for Cardiovascular Interventions (SCAI), published online November 8, 2010 in Catheterization and Cardiovascular Interventions.

Concerns about radiation exposure and its effects during pregnancy are often quoted as important barriers preventing many women from becoming interventionalists, say Best et al. Although women account for half of all medical students, only 18% of cardiology fellows and less than 10% of fellows in interventional cardiology are women. And female cardiac laboratory nurses and radiology technicians may also have concerns regarding their risks with pregnancy, the authors note.

In the 42-page document, the following subjects are covered in detail: risks and concerns specific to the fetus; dose monitoring and radiation assessment; physician issues in procedure type and radiation-dose management; and the legal rights of the pregnant healthcare worker in a number of countries around the world, including the US, Canada, the European Union, and Japan. The results of a SCAI survey on the current radiation safety practices and beliefs of interventional cardiologists are also discussed.

"For women to make informed decisions, a clear understanding of the risk of radiation exposure during pregnancy, including risk to the fetus, is required. Understanding the magnitude of the risk and mechanisms to limit exposure are critical," say Best and colleagues.

The fetal radiation exposure for most women who work in the cardiac cath lab is extremely low and is far lower than limits recommended by the US National Council on Radiation Protection, they state. If a woman wishes to become pregnant, she can wear a radiation badge under the lead apron to determine her own exposure before making decisions, and radiation exposure during pregnancy can be significantly reduced by appropriate fit and thickness of lead aprons, radiation shielding, and maximizing distance from the radiation source, they explain.

"Based on the available evidence, heritable or developmental risks to the fetus of pregnant interventional cardiology physicians and staff are extremely low provided that good radiation safety practices are used and dose limits are respected," they conclude.

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