Contrast Usage

Source: Guidelines for Use of Medical Imaging during Pregnancy and Lactation  Radiographics  copied link

Breastfeeding and contrast:  The dose of iodinated or gadolinium-based contrast medium that reaches the infant through ingestion of breast milk is very small, and only a minute proportion of that which reaches the infant’s gastrointestinal tract is subsequently absorbed. There is insufficient evidence to recommend even a temporary cessation of breast-feeding following the administration of either iodinated or gadolinium-based contrast agents. Because of their higher concentration of free iodide, topical iodine-based disinfectants should be avoided in pregnant and breast-feeding women due to the risk of hypothyroidism in the infant.

Iodinated contrast in pregnancy: Because the fetal thyroid develops throughout pregnancy, any iodine-containing product is contraindicated in pregnant women, given the risk of depression of fetal thyroid function. If iodinated compounds are used in the course of pregnancy, either inadvertently or due to exceptional circumstances, neonatal thyroid function should be checked during the 1st week of life. This testing is already performed routinely for all newborns in North America and Europe. The Committee recommended that iodinated contrast media be used in pregnant women only when (a) no alternative test is available, (b) information to be obtained from the study is useful to both mother and fetus during the pregnancy, and (c) the referring physician considers it imprudent to delay the imaging study until after delivery. If these conditions are met, written informed consent from the parents as to the risks and benefits of the procedure, as well as alternative diagnostic options (when available), are recommended .

Gadolinium in Pregnancy: No known side effects, but due to a lack of long term data it is recommended that imaging be delayed until after pregnancy if possible. If absolutely necessary than informed consent is obtained and the exam can be performed.

Nuclear medicine: If patient is given Tc99m patient should not directly breast feed for 72 hours. Milk should be pumped then frozen/stored. 72 hours after receiving the Tc99m the radioactivity will be essentially gone and the pumped and breast mild are safe to drink. The patient may breastfeed and then pump immediately prior to procedure to have more milk available.

Table 2



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