X-Rays and Pregnancy

Written by yvonnethornton on November 4th, 2013

Many people are concerned about the effects of radiation from X-rays, such as those used for medical diagnoses. Some people become so worried about this that they refuse even important diagnostic X-rays that they need.

The small amount of radiation emitted by X-rays is actually no more dangerous than naturally occurring radiation, such as that from the sun or when you are flying in an airplane at high altitudes.

Low-energy ultraviolet (UV) rays, visible light, infrared rays, microwaves, and radio waves are all forms of non-ionizing radiation.  Ionizing radiation, on the other hand, is generated through nuclear reactions and can alter chemical bonds. Exposure to ionizing radiation causes damage to living tissue, and can result in mutation, radiation sickness, cancer, and death.

Just remember that diagnostic radiation is measured in millirads, while the concern about harming the fetus or embryo is in rads, specifically more than 5 rads.   That means there is 1000 times less radiation in the average diagnostic chest X-ray and one would need to have a thousand chest X-rays in order to reach one rad.   The National Institute of Child Health and Human Development says that a small amount of X-rays are safe even during pregnancy.  Because the fetus is inside the mother, it does benefit from some measure of protection from the effects of radiation. Pregnant women should, however, make sure that they tell their dentists or other doctors or technicians performing X-rays that they are pregnant so that proper precautions can be taken.   But, receiving an X-ray at a dentist’s office or at the hospital is NOT the same as being exposed to the amount of radiation emitted from Chernobyl or Hiroshima.  People exaggerate the harm of these medical diagnostic X-rays to the detriment of the mother because she may be denied appropriate imaging studies in order to diagnose a medical condition that, in and of itself, may worsen without the knowledge gained from the diagnostic X-ray.

With most decisions you make during the course of your pregnancy, you will want to weigh the risks against the benefits of any particular action and choose the option that is best for you and your baby.  According to the American College of Radiology, “no single diagnostic procedure results in a radiation dose significant enough to threaten the well-being of the developing embryo or fetus.” This statement was made over 20 years ago and it still rings true today.  So, why all the hysteria?  Ignorance and fear of possible lawsuits.  It’s important to remember that with X-rays, often not getting the X-ray will be the more harmful choice. X-rays have been shown to be quite safe, and even if you are still worried about the radiation exposure, keep in mind that your undiagnosed infection, condition, or injury may turn out to be much more harmful and may lead to death.

It is true that there is an abundance of misinformation and dysinformation surrounding the topic of X-rays during pregnancy. With that said, it is a good idea to limit X-rays to those that are imperative. Routine dental X-rays, for example, should wait until after your baby is born, while  X-rays of the lung to rule out tuberculosis or to investigate a troublesome symptom should not be delayed. Remember that X-rays save lives in many cases because of the information they provide for your doctor about your condition.

To reiterate, the fact is that diagnostic X-rays pose no threat to your unborn baby. Especially in the case of one-time X-rays that do not involve the lower pelvis, such as those that image the chest, arms, or legs.  Serial or cumulative X-rays and CT scans are another concern and should be limited during the course of the pregnancy.  MRI’s are not ionizing radiation, but rather powerful magnets which temporarily alter the energy state.

What if you had an X-ray before you knew you were pregnant? Don’t worry. The chance that it caused any harm is infinitesimal.  At that very early stage of pregnancy, the body invokes the “all or nothing” principle.  Either there is no harm at all or the body rejects the abnormal embryo, resulting in a miscarriage (spontaneous abortion).  If you are concerned about X-rays you had early in your pregnancy before you were aware the pregnancy existed, a discussion with your doctor should allay your fears.   Now that you know you are pregnant, be sure your doctor knows it when he or she orders X-rays for any condition. This is important for any treatment a doctor orders such as prescriptions and certain medical procedures as well as X-rays.

Occasionally, a woman may have X-rays to diagnose a mysterious “illness” that turns out to be pregnancy. Fifty percent of all pregnancies are unintended.  Therefore, if you are sexually active, you may be pregnant and you need to discuss that with your doctor before moving on to other diagnostic tests or treatments.

Finally, if your doctor wants you to have X-rays, inform him or her of any other X-rays you may have had in the recent past or before you were pregnant, so that they might be able to look at them instead of ordering new X-rays. This can help you avoid unnecessary X-rays, but again, if you do need X-rays, remember that refusing them is likely to be more detrimental to your health and that of your baby as compared to having an X-ray which could save your life by diagnosing or ruling out the problem.

– Yvonne S. Thornton, M. D., M. P. H.

 

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