Röntgen-, MR- oder Ultraschallkontrastmittel während der Schwangerschaft oder Stillzeit: Was ist zu beachten?

J. M. Fröhlich; R. A. Kubik-Huch

doi:10.1055/s-0032-1325396

RöFo - Fortschritte auf dem Gebiet der Röntgenstrahlen und der bildgebenden Verfahren, Table of Contents

Rofo 2013; 185(1): 13-25
DOI: 10.1055/s-0032-1325396

Übersicht

Röntgen-, MR- oder Ultraschallkontrastmittel während der Schwangerschaft oder Stillzeit: Was ist zu beachten?

Radiographic, MR or Ultrasound Contrast Media in Pregnant or Breast-Feeding Women: What are the Key Issues?

J. M. Fröhlich

¹Guerbet Zürich, Guerbet AG

,

R. A. Kubik-Huch

²Institut für Radiologie, Kantonsspital Baden AG

› Author Affiliations

Abstract

Zusammenfassung

Der Umgang mit und die Sicherheit der Röntgen-, MR- oder Ultraschallkontrastmittel bei bildgebenden Abklärungen der Schwangeren wie auch der stillenden Mutter ist eine häufig gestellte Frage. Da nur bedingt klinische Daten vorliegen, müssen bei der Nutzen-Risikobeurteilung physiko-chemische Grundlagen, präklinische Daten mit Teratogenität und Embryotoxizität sowie das Expositionsausmaß mit in die Beurteilung einbezogen werden. Jodierte Kontrastmittel, stabilere makrozyklische MR-Kontrastmittel oder Schwefelhexafluorid-Ultraschallkontrastmittel können unter Beachtung der individuellen Risiken über die ganze Schwangerschaft hinweg, falls klinisch gerechtfertigt, in möglichst geringen Dosen verabreicht werden. Nach parenteraler Gabe eines jodierten Kontrastmittels nach der 12. SSW sollte die Schilddrüsenfunktion des Neugeborenen innerhalb der ersten Lebenswoche überprüft werden. Nach der parenteralen Gabe jodierter, stabiler makrozyklischer gadoliniumhaltiger oder von Ultraschallkontrastmitteln kann das Stillen normal fortgesetzt werden. Auf jeden Fall sollten Kontrastmittel zurückhaltend und nur bei positivem Nutzen-Risiko Verhältnis eingesetzt werden.

Abstract

The use and the safety of radiographic, MR- or ultrasound contrast media in the diagnostic work-up of pregnant or lactating patients is a frequently discussed question. As only sparse clinical data is available, a careful benefit-risk assessment must contain physico-chemical properties, preclinical data including teratogeneity and embryotoxicity, as well as maternal and foetal exposure. With consideration to the individual risks, iodinated contrast media, macrocyclic MR contrast media with increased stability or sulphur hexafluoride ultrasound contrast media may, if clinically justified, be administered in the smallest possible doses throughout pregnancy. After parental administration of an iodinated contrast medium after the 12th week of pregnancy, the neonate’s thyroidal function should be checked during the first week after birth. After parental administration of iodinated, stable macrocyclic, gadolinium or ultrasound contrast media, lactation can be continued normally. In any case, contrast media should be used with caution and only if the benefits outweigh the risk.

Key words

genital/reproductive - contrast agents - fetus

Full Text

References

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