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Jul 1 2006, 6:38 AM EDT (current) AndyC 14 words deleted
Jul 1 2006, 6:32 AM EDT AndyC

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Iodinated Contrast Media in Pregnancy


In general, intravascular contrast media should be avoided in pregnancy, in order to avoid any possible hazard to the fetus. In vitro experiments have shown iodinated contrast to be mutagenic to human cells [1]. Animal studies have failed to show an in vivo teratogenic effect [2, 3]. The iodine content of contrast media has the potential to produce neonatal hypothyroidism, and this has been observed after the direct instillation of ionic contrast into the amniotic cavity during amniofetography [4]. The intravascular use of non-ionic contrast media has been reported to have no effect on neonatal thyroid function [5]. It is standard pediatric practice to screen all neonates for hypothyroidism, but it is particularly important to perform this test in the infants of mothers who received iodinated contrast during pregnancy [6].
Key point:
Despite in vitro concerns, iodinated contrast seems safe to use in pregnancy.

References
  1. Nelson JA, Livingston JC, Moon RG. Mutagenic evaluation of radiographic contrast media. Invest Radiol 1982; 17: 183-185.
  2. Morisetti A, Tirone P, Luzzani F, de Haen C. Toxicologic safety assessment of iomeprol, a new x-ray contrast agent. Eur J Radiol 1994; 18 (Suppl 1): 21-31.
  3. Ralston WH, Robbins MS, James P. Reproductive, developmental, and genetic toxicity of ioversol. Invest Radiol 1989; 24 (Suppl 1): 16-22.
  4. desch F, Camus M, Ermans AM, et al. Adverse effects of amniofetography on fetal thyroid function. Am J Obstet Gynecol 1976; 126: 723-726.
  5. na G, Zaffaroni M, Defilippi C, et al. Effects of iopamidol on neonatal thyroid function. Eur J Radiol 1992; 12: 22-25.
  6. Webb JA, Thomsen HS, Morcos SK; Members of Contrast Media Safety Committee of European Society of Urogenital Radiology (ESUR). The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol 2005; 15: 1234-1240.