Risk and the Pregnant Body

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Acta Clinica Croatica, 2016

-Th ere are many false assumptions, both in the general population and among physicians, regarding the infl uence of radiation on pregnant patients and the fetus during diagnostic procedures, in spite of scientifi c facts based on studies. Th ese false assumptions are mostly based on the idea that every diagnostic procedure using ionizing radiation is a cause for serious concern and that artifi cial abortion as a possible solution might be considered. We analyzed data from counseling of pregnant patients exposed to ionizing radiation during diagnostic procedures in the Merkur University Hospital during a 4-year period. In this period, 26 patients presented for counseling after exposure to diagnostic ionizing radiation during pregnancy. Results showed most of these patients to have been exposed to radiation between the 2 nd and 3 rd week of gestation (36%), between the 4 th and 5 th week 32%, before the 2 nd week 24%, and after the 6 th week of gestation less than 8%. To provide reasonable estimate of fetal doses, Report No. 174 from the National Council on Radiation Protection and Measurements (NCRP) was used. Data from the Report include estimate of the fetal dose from direct and indirect exposures. Th e mean doses were up to 0.01 cGy in 46.2%, 0.01-0.15 cGy in 19.2%, 0.2-1 cGy in 26.9% and 1 cGy or more in 7.7% of patients. None of the counseled patients had medical indication for abortion, even though in a small percentage of patients abortion was a personal subjective decision. Considering that there are no Croatian guidelines for counseling patients exposed to ionizing radiation during pregnancy, it is recommended to use the International Commission on Radiological Protection guidelines in the management of pregnant patients exposed to ionizing radiation.

Current Opinion in Anaesthesiology, 2004

Accidental lllJUry during pregnancy is both common and unique, not only because two lives are involved but also because of alterations in the nature of and response to injury. Trauma to the gravid patient has become increasingly more common, often presenting the physician with both perplexing medical and potential legal problems. Today's women are more exposed to the rigors and dangers of our society. Because of economic necessity, and by choice, more women are working outside of the home; their jobs are more hazardous and require more traveling in faster but smaller cars, as well as motorcycles. Contemporary women have increased exposure to injury because of greater participation in sports, both conditioning and competitive. Moreover, today's woman does not seclude herself when pregnant. Accidental injury is estimated to occur in 6 to 7 per cent of all pregnancies. Various state and hospital maternal mortality committees continue to report accidents as one of the common nonobstetric causes of death among pregnant women. 2 , 8, 25 Insurance reports continue to list automobile accidents as a leading cause of death due to trauma, followed by violent assault (first guns, then penetrating instruments), followed by suicide. Pregnancy also evokes increased activity within the home; a new room must be added or the nursery refurbished, the walls pain.ted and the curtains hung, and this accomplished on a ladder or chair by the unsteady mother-tobe. Easy fatigability, fainting spells, and hyperventilation commonly occur owing to the ulilpredictable physiologic changes in pregnancy. The protuberant abdomen, loosening of the• pelvic joints, and pelvic pressures that cause pain and neuromuscular dysfunction of the lower extremities cause a general clumsiness. The pregnant woman spends more time on hygiene in the bathroom (and more time in the kitchen) where tile and porcelain surfaces are slippery and hard and there is no soft spot to fall upon. All of these factors set the scenario for accidental injury during pregnancy. .-Major trauma to the pregnant woman is often viewed as a double tragedy by attending medical personnel in the emergency room setting. The lack of familiarity with the physiologic and anatomic changes occuring during gestation, the fear of impending delivery, and the awareness of possible litigation .and legal accountability may lead to relat~ve diagnostic and thera

It is necessary to differentiate between complications of pregnancy and population risk groups for those complications. The latter have limited use as most complications occur in the low risk groups. Complications of pregnancy need to be treated in health facilities that can provide blood transfusions, cesarean section, removal of placenta and induction of labor. A plan must exist for each pregnant woman to be moved to such a facility, since it is not possible to predict who will have thecomplication. Early detection andeffective treatment of complications and family planning services to prevent unwanted pregnancies is the way to lower maternal mortality.

IAR Consortium, 2021

Forty pregnant women patients were collected from Al Karama Educational Hospital, Al-Shaheed Dari Al-Fayad Hospital, Baghdad, Iraq, and Al_Hindiya general hospital, Karbala, Iraq. The results showed that most of these patients were exposed to radiation between the second and third weeks of pregnancy. Women exposed to ionizing radiation during pregnancy, where the advice from an official in charge of radiation protection was considered, in addition to the fact that the dose had several limitations, including the type of device used and the procedures used. Therefore, the calculation of the received amount was more accurate if it was calculated for each device correctly individual in some cases. For most cases of radiation exposure, the radiation dose in which the fetus is exposed is less than that to which the mother is exposed, and the stomach of the pregnant mother works in part to protect the fetus from the sources of radiation outside the body. Health problems on the fetus may be from exposure Radiation is dangerous, even at the low radiation doses that May does not cause disease to the mother. Health problems may include miscarriage and stunted growth Malformations, brain dysfunction, and cancer. The fetus is most sensitive to radiation at two weeks of age to 18 weeks of pregnancy, and the fetus is less susceptible to radiation during the stage's Subsequent pregnancy.

Journal of Pharmacokinetics and Pharmacodynamics, 2020

The extensive metabolic demands of pregnancy require specific physiological and anatomical changes. These changes affect almost all organ systems, including the cardiovascular, respiratory, renal, gastrointestinal, and hematologic system. The placenta adds another layer of complexity. These changes make it challenging for clinicians to understand presenting signs and symptoms, or to interpret laboratory and radiological tests. Furthermore, these physiological alterations can affect the pharmacokinetics and pharmacodynamics of drugs. Postpartum physiology includes the return to pre-pregnancy physiology, and lactation with drug safety concerns, commonly only supported by limited evidence. In addition, the teratogenic effects of medications are often extrapolated from animals, which further adds uncertainties. Unfortunately, pregnant women are only rarely included in clinical drug trials, while doses, regimens, and side effects are often extrapolated from studies conducted in non-pregnant populations. In this comprehensive review, we present the changes occurring in each system with its effects on the pharmacokinetic variables. Understanding these physiological changes throughout normal pregnancy helps clinicians to optimize the health of pregnant women and their fetuses. Furthermore, the information on pregnancy-related physiology is also critical to guide study design in this vulnerable 'orphan' population, and provides a framework to explore pregnancyrelated pathophysiology such as pre-eclampsia. Terms of use and reuse: academic research for non-commercial purposes, see here for full terms. https://www.springer.com/aamterms-v1

383 This article was published in an Sjournals journal. The attached copy is furnished to the author for non-commercial research and education use, including for instruction at the authors institution, sharing with colleagues and providing to institution administration. Other uses, including reproduction and distribution, or selling or licensing copied, or posting to personal, institutional or third party websites are prohibited. In most cases authors are permitted to post their version of the article (e.g. in Word or Text form) to their personal website or institutional repository. Authors requiring further information regarding Sjournals΄s archiving and manuscript policies encouraged to visit: http://www.sjournals.com A B S T R A C T Diseases in pregnancy are rare, and in most cases the growth and development of the baby does not in the least impair the health of the mother. However, during this dynamic period, numerous and rapid changes occur in the body of the pregnant woman, which inevitably affect her life, daily activities and indirectly affect her loved ones. This paper discusses some illnesses and conditions that can occur in pregnancy.

Journal of Vascular Surgery, 2011

The effect of radiation on the fetus has been derived primarily from animal studies and human exposures to diagnostic and therapeutic radiation as well as atomic bomb exposure. Given the variety of sources, there is controversy over the dose of radiation in addition to the other environmental conditions that surrounded these events and their relationship to exposure today. Methods: The effects of ionizing radiation on the fetus, the prenatal period, parental exposure, the pregnant clinician, and the pregnant patient are discussed in the context of their exposure to radiation. Results: The fetus is most sensitive to radiation effects between 8 and 15 weeks of pregnancy. Stepping away from the table and using movable shields help reduce the exposure by a factor of four for every doubling of the distance between the operator and the radiation source. Conclusion: Proposed guidelines for pregnancy during vascular residency training involving fluoroscopic procedures can help bring about awareness, clarify maximal exposure, and better delineate the role of the pregnant resident. ( J Vasc Surg 2011;53:28S-34S.)