Neuroimaging During Pregnancy and Lactation

Created 06/06/2022, last revision 04/05/2023

  • ultrasound and magnetic resonance imaging (MRI) are not associated with increased risk and are the imaging modalities of choice for pregnant women (ACOG Guidelines 2017)
  • still, they should be used with caution (especially MRI) and only when their use is expected to answer a relevant clinical question or otherwise provide medical benefit to the patient
Fetal radiation dose caused by different diagnostic methods
Computed tomography (CT)
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Magnetic resonance imaging (MRI)
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  • neurosonology is entirely safe for both the mother and the fetus – it is the preferred method for diagnosis and monitoring of occlusions and stenoses during pregnancy
  • ultrasound is also a safe method for examination of the fetus – the ALARA principle should be followed with regard to the amount of energy (max intensity < 720 mW/cm2)
    • thermal effect on the fetus is highest with the color and Doppler mode and  lowest with the B mode – use obstetric presets
Angiography (DSA)
  • mostly reserved for interventional procedures only – e.g., mechanical thrombectomy (MT), etc.
    • pregnant women were excluded from randomized trials with MT, but the benefit can be assumed ⇒ pregnancy is, therefore, a relative contraindication to MT
    • published case reports show good maternal and fetal outcomes [Blythe, 2019]
  • careful fetal shielding with a lead apron is required!

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Neuroimaging during pregnancy and lactation