Comprehensive Analysis: MRI Safety Procedures During Pregnancy

This assignment examines the safety of MRI procedures during pregnancy, drawing on multiple sources to assess potential risks and established guidelines. The student analyzes a retrospective cohort study by Ray, Vermeulen, Bharatha, Montanera, & Park (2016), which supports the existing literature on the safety of using MRI during pregnancy, particularly in the second and third trimesters. The assignment also references guidelines from the University of California San Francisco (2019) regarding the use of CT and MRI during pregnancy, emphasizing the avoidance of gadolinium and adherence to ACR guidelines for pregnant employees. Finally, it includes an article by Bakalar (2016) which suggests MRI is safe during pregnancy unless contrast agents like gadolinium are used. The student ranks the sources based on reliability, and provides a reference list. The assignment highlights the importance of considering the level of evidence when evaluating the safety of medical imaging during pregnancy, especially concerning the use of contrast agents like gadolinium.

Running head: SAFETY OF MRI PROCEDURE DURING PREGNANCY 1
Safety of MRI Procedure during Pregnancy
Student’s Name
University

SAFETY OF MRI PROCEDURE DURING PREGNANCY 2
Safety of MRI Procedure during Pregnancy
Ray, Vermeulen, Bharatha, Montanera, & Park (2016) retrospective cohort study
supported the existing literature on the safety of using MRI during pregnancy. This study is
based on the increased reliance on medical imaging in clinical settings. The risk of this method
in pregnancy during the first trimester has been associated with the ionization radiation which
causes different effects on the fetus. This study focused on the use of MRI in the second and
third trimester in the scanning of the fetus for different clinical reasons. This means that no
documented evidence has been presented with the risk of using MRI during pregnancy.
However, the study failed to detect the rare adverse effects of MRI during the first trimester. This
means that the clinician needs to choose the modality that has little ionization effect like MRI
and ultrasound. According to Murad, Asi, Alsawas, & Alahdab (2016) cohort studies are placed
third last in the evidence pyramid. This resource is the highest based on the ones that have been
used in this essay.
University of California San Francisco (2019) website offers guidelines for use of CT and
d\MRI during pregnancy and lactation. The guidelines suggest that gadolinium must be avoided
due to the risks that it poses to the patient and if it is used then the consent must be obtained from
the patient. The guidelines also require that pregnant employees in the MRI environment have to
be guided by ACR Guidance Document on MR Safe Practices: 2013, under Health Care
Practitioner Pregnancies which permit pregnant women to work in the MR environment but are
not supposed to remain in scan room or MRI scanner bore during the actual acquisition of data.
Further, there is a need for the radiologists to determine whether the patient is pregnant if the
patient falls within the childbearing age. Under such conditions, the radiology should not be
exposed to the pelvis unless this has been done in consultation with the radiologist. These

SAFETY OF MRI PROCEDURE DURING PREGNANCY 3
guidelines are supposed to be used in all cases to avoid any complications that relate to the use of
MRI in pregnant women. This level of evidence also falls under unfiltered studies under case
series or reports which form the second-lowest level of evidence in a research pyramid (Murad,
Asi, Alsawas, & Alahdab, 2016).
Bakalar (2016) suggests that there is no danger on the fetus when the MRI is used in
pregnant women. This article is based on a conclusion after tracking 1,424,105 deliveries of
living and stillborn infants. This group entailed 5,654 women who had been exposed to MRIs
and who had an MRI with gadolinium as a contrast agent. Bakalar (2016) article adds that there
was a high risk of MRI effects on congenital abnormalities on patients who had MRI with other
agents. This article concluded that there is no problem for undergoing MRI unless if there is the
use of a contrast agent like gadolinium which requires consulting with the doctor in charge. An
article is an expert opinion which is based on the gathering of background information for any
study. This is the lowest level of evidence since it falls below unfiltered evidence including
background information (Murad, Asi, Alsawas, & Alahdab, 2016).

SAFETY OF MRI PROCEDURE DURING PREGNANCY 4
References
Bakalar, N. (2016, September 20). Regular M.R.I. Is Safe During Pregnancy. The NewYork
Times.
Murad, M. H., Asi, N., Alsawas, M., & Alahdab, F. (2016). New evidence pyramid. BMJ
Evidence-Based Medicine, 21, 125-127. doi:http://dx.doi.org/10.1136/ebmed-2016-
110401
Ray, J. G., Vermeulen, M. J., Bharatha, A., Montanera, W. J., & Park, A. L. (2016). Association
Between MRI Exposure During Pregnancy and Fetal and Childhood Outcomes.
JAMA(316), 52-961. d. doi:.1001/jama.2016.12126
UniversityofCaliforniaSanFrancisco. (2019). CT and MR Pregnancy Guidelines. Retrieved 2019,
from University of California, San Francisco:
https://radiology.ucsf.edu/patient-care/patient-safety/ct-mri-pregnancy#accordion-
pregnancy-and-mri-inpatients