Lung Scintigraphy for Suspected Pulmonary Embolism During Pregnancy: Fetal Radiation Dose and Pregnancy, Neonatal, and Childhood Outcomes
This retrospective study of 44 pregnant patients suggests that lung scintigraphy for suspected pulmonary embolism delivers a low fetal radiation dose and is associated with generally reassuring pregnancy and childhood outcomes, though definitive conclusions about long-term safety are limited by the small sample size and lack of a control group.
Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer
When a pregnant woman arrives at the hospital with sudden shortness of breath or chest pain, doctors face a difficult puzzle. These symptoms are common in pregnancy due to natural changes in the body, but they can also signal a life-threatening blood clot in the lungs, a condition known as pulmonary embolism. Finding the clot is urgent because it can be fatal, yet the tools used to diagnose it often involve radiation, which raises concerns about the safety of the developing baby. For decades, medical guidelines have debated which imaging test offers the best balance: a scan that uses a special camera to see how blood flows through the lungs, or a CT scan that uses X-rays to create detailed pictures of the chest. While both methods are considered acceptable, the camera-based scan is often preferred for pregnant patients because it can be done with a very low amount of radiation, particularly if doctors only look at blood flow and skip the part that checks how air moves in and out. However, while doctors knew the radiation dose was low, they had very little real-world data on what actually happened to the mothers and children years after the scan.
To fill this gap, researchers at Akdeniz University in Turkey looked back at the medical records of forty-four pregnant women who had undergone this specific lung scan between 2013 and 2024. These women had been referred for the test because their doctors suspected a blood clot. The study team carefully tracked the details of the procedure, calculating exactly how much radiation the babies received based on the amount of radioactive liquid injected into the mothers and how far along the pregnancy was. They then followed up with the families, sometimes years later, to see how the pregnancies ended, how the babies were born, and whether the children grew up healthy. The goal was not just to measure the radiation, but to see if that exposure left any trace on the health of the mother or child.
The results showed that the radiation dose the babies received was remarkably small. On average, the estimated dose was 0.180 milligray, a unit used to measure absorbed radiation, with the highest recorded dose being 0.401 milligray. Most of the scans were performed in the third trimester, and the vast majority of the women received a very low amount of the radioactive tracer, just 1.0 millicurie. The scans themselves provided clear answers for the doctors: in eight cases, the images showed a blood clot, and in four more, the results were unclear enough to warrant treatment. In the remaining thirty-two cases, the scans showed no evidence of a clot. Because the diagnosis was so critical, every woman whose scan suggested a clot or was uncertain received blood-thinning medication to protect her and the baby.
The follow-up data painted a reassuring picture for the mothers and their children. Among the thirty-one pregnancies where the outcome was known, there were no deaths and no recurring blood clots in the mothers. The babies were born with a mix of outcomes typical for a high-risk group, including some preterm births and low birth weights, but these complications appeared linked to the underlying medical conditions that led to the scans rather than the scans themselves. Crucially, no major birth defects were found in the newborns. As the children grew, the researchers tracked their health for an average of five years, with some followed for over a decade. In this group of thirty children, there were no cases of childhood cancer or leukemia. One child had a heart defect that closed on its own, and a few had common childhood issues like attention difficulties or frequent colds, but nothing that pointed to the radiation exposure.
The researchers concluded that using this low-dose lung scan during pregnancy appears to be safe for the developing fetus, with the radiation exposure being minimal and the long-term health of the children looking normal. However, they were careful to note that their study was small and focused on a single hospital, meaning they could not definitively prove that there is zero risk. The absence of problems in this group suggests safety, but the authors emphasized that larger studies with more families and longer follow-up periods are still needed to confirm these findings with absolute certainty. For now, the data offers strong reassurance that when a pregnant woman needs this specific test to save her life, the risk to her baby is likely negligible.
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