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Contrast Agents in Pregnancy and Breastfeeding

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Medical Imaging Contrast Agents: A Clinical Manual

Abstract

The use of radiological modalities during pregnancy and lactation has increased substantially in recent years, and studies requiring contrast agent use also contribute to this increment. If a contrast-enhanced modality is being used during pregnancy or lactation, besides the exposure to ionizing radiation and high magnetic field, potential harmful effects related to contrast media should also be considered. Radiologists must have detailed knowledge regarding the use of contrast agents during pregnancy and lactation in order to inform the referring clinicians and patients about the procedure.

The objective of this chapter is to review the types (iodinated contrast media, gadolinium-based contrast agents, barium and ultrasound contrast agents), transplacental transfer, breast-milk excretion and potential harmful effects of contrast agents, as well as up-to-date recommendations regarding the use of contrast media in pregnancy and lactation. It is also aimed to give information about preprocedural and postprocedural counseling and management of allergic reactions following contrast agent use during pregnancy.

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Abbreviations

ACLS:

Advanced cardiovascular life support

ACOG:

The American College of Obstetricians and Gynecologists

ACR:

The American College of Radiology

CSF:

Cerebrospinal fluid

CT:

Computed tomography

ESUR:

The European Society of Urogenital Radiology

FDA:

The Food and Drug Administration

GBCA:

Gadolinium-based contrast agent

HOCM:

High-osmolar contrast media

HSG:

Hysterosalpingography

IV:

Intravenous

LOCM:

Low-osmolar contrast media

MRI:

Magnetic resonance imaging

PO:

Per Os

SAR:

Specific absorption rate

TSH:

Thyroid-stimulating hormone

USCA:

Ultrasound contrast agent

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Authors and Affiliations

  1. Radiology, Istanbul University-Cerrahpasa Cerrahpasa Medical Faculty, Istanbul, Turkey

    Bora Korkmazer

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  1. Bora Korkmazer
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Editors and Affiliations

  1. Department of Radiology, Istanbul University School of Medicine, Istanbul, Turkey

    Sukru Mehmet Erturk

  2. Departments of Radiology and Pathology, Stony Brook University, Stony Brook, NY, USA

    Pablo R. Ros

  3. Departments of Diagnostic Radiology and Nuclear Medicine, Gunma University, Graduate School of Medicine, Maebashi, Gunma, Japan

    Tomoaki Ichikawa

  4. Department of Radiology, EskiÅŸehir Osmangazi University, Eskisehir, Turkey

    Suzan Saylisoy

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Korkmazer, B. (2021). Contrast Agents in Pregnancy and Breastfeeding. In: Erturk, S.M., Ros, P.R., Ichikawa, T., Saylisoy, S. (eds) Medical Imaging Contrast Agents: A Clinical Manual. Springer, Cham. https://doi.org/10.1007/978-3-030-79256-5_11

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