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E2158. Interventional Radiology: Considerations in Pregnancy
Authors
  1. Savannah Fletcher; University of California, Los Angeles
  2. Iris Chen; University of California, Los Angeles
  3. Aarti Luhar; University of California, Los Angeles
  4. Simin Bahrami; University of California, Los Angeles
Background
Radiation effects pose an inherent risk in interventional radiology (IR) procedures, and this risk is particularly magnified for patients in the context of pregnancy.

Educational Goals / Teaching Points
This educational exhibit will review the physiologic changes in pregnancy and how these changes influence common pathology treated with IR. We will discuss the differences between deterministic and stochastic radiation effects and the radiation dose estimates to the mom and fetus in common IR procedures. The exhibit will delineate specific perioperative procedure considerations in the context of each common IR procedure that may be indicated in pregnancy.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The key pathophysiologic issues for appropriate management of pregnancy patients in the context of IR procedures includes understanding the physiologic changes in pregnancy and radiation dose effects for both mom and fetus in IR procedures. Guidelines for perioperative considerations in pregnant patients include understanding procedure indication, reviewing informed consent in the context of pregnancy, getting maternal-fetal and anesthesia involved early, selecting medication in the context of pregnancy, positioning the patient appropriately, minimizing radiation exposure minimization. This presentation will review the imaging findings and treatment considerations for common IR procedures that may be indicated in pregnancy including pulmonary arteriovenous malformation embolization, uterine fibroid embolization, hysterosalpingography, ureteric stent placement, and transjugular intrahepatic portosystemic shunt creation.

Conclusion
As IR procedures may be indicated in pregnant patients, it is essential to understand the challenges in managing pregnant patients perioperatively in the context of imaging and radiation effects.