martes, 1 de julio de 2014

National Guideline Clearinghouse | The use of magnetic resonance imaging in the obstetric patient.

full-text ►

National Guideline Clearinghouse | The use of magnetic resonance imaging in the obstetric patient.

Society of Obstetricians and Gynaecologists of Canada

Guideline Title

The use of magnetic resonance imaging in the obstetric patient.

Bibliographic Source(s)

Patenaude Y, Pugash D, Lim K, Morin L, Diagnostic Imaging Committee, Lim K, Bly S, Butt K, Cargill Y, Davies G, Denis N, Hazlitt G, Morin L, Naud K, Ouellet A, Salem S. The use of magnetic resonance imaging in the obstetric patient. J Obstet Gynaecol Can. 2014 Apr;36(4):349-55. PubMed External Web Site Policy

Guideline Status

This is the current release of the guideline.

2014 Apr;36(4):349-63.

The use of magnetic resonance imaging in the obstetric patient.

[Article in English, French]

Patenaude Y1, Pugash D2, Lim K2, Morin L3; Diagnostic Imaging Committee, Lim K2, Bly S4, Butt K5, Cargill Y4, Davies G6, Denis N7, Hazlitt G8, Morin L3,Naud K9, Ouellet A1, Salem S10.

Author information

Abstract

in English, French

OBJECTIVE:

To review the biological effects and safety of magnetic resonance imaging (MRI) in the obstetric patient and to review procedural issues, indications, and contraindications for obstetrical MRI.

OUTCOMES:

This guideline is intended to reassure patients and clinicians of the safety of MRI in pregnancy and to provide a framework for its use.

EVIDENCE:

Published literature was retrieved through searches of PubMed or Medline in 2013 using controlled vocabulary and key words (e.g., MRI, safety, pregnancy). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English and in French. There were no date restrictions. Searches were updated on a regular basis and incorporated in the guideline to July 2013. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.

VALUES:

The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table).

BENEFITS, HARMS, AND COSTS:

This article is intended to reassure obstetric care providers that if used in an appropriate manner without the use of contrast agents, MRI in the obstetrical patient is safe for mother and fetus in the second and third trimesters. Because obstetrical MRI is expensive and has limited availability in Canada, this clinical guideline is intended to encourage the judicious use of this resource. SUMMARY STATEMENTS: 1. Fetal magnetic resonance imaging is safe at 3.0 tesla or less during the second and third trimesters. (II-2) 2. It is safe to continue breastfeeding after receiving a gadolinium contrast agent. (III) RECOMMENDATIONS: 1. Use of magnetic resonance imaging during the first trimester of pregnancy should be restricted to maternal indications for which the information is considered clinically imperative. Inadvertent exposure to magnetic resonance imaging during the first trimester has not been associated with any long-term sequelae and should not raise clinical concern. (III-C) 2. Gadolinium contrast may be used in pregnant women when the benefits outweigh the potential risks. (III-C).