Some pregnant women exposed to gadolinium during first trimester
A small number of women are exposed to gadolinium-based contrast agents (GBCAs) during the early stages of pregnancy, according to new findings published in Radiology. What can be done to limit such exposure going forward?
Recent research has suggested that gadolinium can be retained in the body long after GBCA exposure during imaging procedures. The use of GBCAs with pregnant patients is not recommended unless absolutely necessary, and the study’s authors noted that more information is still needed on its potential impact.
“Limited data are available on the effects of in utero GBCA exposure. GBCA crosses the placenta and enters the fetal circulation,” wrote Steven Bird, PharmD, PhD, of the FDA’s division of epidemiology and colleagues. “After excretion into the amniotic fluid via fetal urination, GBCAs are swallowed by the fetus to create a cyclic re-exposure pattern. This increases the potential for dissociation of gadolinium from the ligand and retention of free gadolinium in the fetus.”
To track the prevalence of GBCA exposure among pregnant women, the authors explored data from more than 4.5 million live births that occurred from 2006 to 2017. Overall, GBCA exposure was identified in just 1 in 860 pregnancies—or 0.12%—and nearly three-quarters of those instances occurred during the first trimester of the pregnancy.
The researchers noted that providers should take action to keep these unintentional exposures to a minimum.
“Unintended fetal exposures to gadolinium can occur during early pregnancy among women who are not yet aware they are pregnant,” Bird said in a prepared statement. “Increased attention to existing pregnancy screening measures may help reduce inadvertent exposures to gadolinium contrast.”
Paperwork specifically asking patients abut the potential for pregnancy, directly asking patients before all MRI scans and even testing patients for pregnancy when appropriate are all methods suggested by Bird et al. to reduce the number of pregnant women exposed to GBCAs.
Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.