Rofo 2021; 193(07): 778-786
DOI: 10.1055/a-1313-7527

Prenatal radiation exposure in diagnostic and interventional radiology

Article in several languages: English | deutsch
Martin Fiebich
1   Institute of Medical Physics and Radiation Protection, University of Applied Sciences Giessen, Germany
Andreas Block
2   Institute for Medical Radiation Physics and Radiation Protection, Hospital of Dortmund gGmbH, Dortmund, Germany
Markus Borowski
3   Institute of Radiology and Nuclear Medicine, Municipal Hospital Braunschweig, Germany
Lilli Geworski
4   Department of medical physics and radiation protection, Hannover Medical School, Hannover, Germany
Christian Happel
5   Department of Nuclear Medicine, Goethe University Frankfurt; University Hospital, Frankfurt am Main, Germany
Alexandra Kamp
6   Department Medical and Occupational Radiation Protection, Federal Office for Radiation Protection Neuherberg, Germany
Horst Lenzen
7   Department of Clinical Radiology, University Hospital Münster, Germany
Andreas H. Mahnken
8   Department of Diagnostic and Interventional Radiology, Phillips University Marburg; Marburg University Hospital, Marburg, Germany
Wolfgang-Ulrich Müller
9   Institute of Medical Radiation Biology, University Hospital Essen, Germany
Gebhard Östreicher
10   Medical Physics and Radiation Protection, University Hospital Augsburg, Germany
Frank Rudolf
4   Department of medical physics and radiation protection, Hannover Medical School, Hannover, Germany
Georg Stamm
11   Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany
Peter Starck
12   Institute of Diagnostic and Interventional Radiology, Medical Physics, Städtisches Klinikum Karlsruhe gGmbH, Karlsruhe, Germany
Beatrice Steiniger
13   Department of Diagnostic and Interventional Radiology, Jena University Hospital, Jena, Germany
Jan-Henryk Wicke
4   Department of medical physics and radiation protection, Hannover Medical School, Hannover, Germany
Ulrich Wolf
14   Department of Radiation Oncology, University Hospital Leipzig, Germany
Michael Wucherer
15   Institute of Medical Physics, Nuremberg General Hospital, Paracelsus Medical University, Nuremberg, Germany
Maria Zankl
16   Institute of Radiation Medicine, Helmholtz Zentrum München German Research Center for Environmental Health, Neuherberg, Germany
Klemens Zink
1   Institute of Medical Physics and Radiation Protection, University of Applied Sciences Giessen, Germany
Claudia Zweig
17   Clinic for Radiooncology and Radiotherapy; Department Medical Radiological Physics, Hospital Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus, Germany
› Author Affiliations


Background The exposure of a pregnant woman to X-rays is an event that can cause uncertainty for all concerned. This review provides guidance on how to assess such a situation and how to determine the dose to the unborn child. In general, the use of X-rays in pregnant women in radiology should be avoided. If possible, alternatives should be used, or examinations postponed to a time after the pregnancy. This review gives a summary of the procedure for determining the radiation exposure of a pregnant woman.

Method Based on the previous report of 2002 and the literature on prenatal radiation exposure published thereafter, the DGMP/DRG report on the procedure for the assessment of prenatal radiation exposure was adapted to the current state of science and technology.

Results Typically, only relatively low radiation exposures of less than 20 mSv occur for the unborn child in X-ray diagnostics in the vast majority of cases. At these dose level the additional risk of damage to the embryo or fetus caused by the radiation is low and therefore only a rough conservative estimate using tabulated values are made. Only in a few types of examination (CT and interventional radiology) higher doses values might occur in the uterus. Instead of dose estimates (step 1 in the two-step model) in these cases the calculation of dose (step 2) are required and further action by the physician may be necessary.

Conclusions During the assessment, it is useful to initially use simple conservative estimation procedures to quickly determine whether a case falls into this large group less than 20 mSv, where there is a very low risk to the unborn child. If this is the case, the pregnant woman should be informed immediately by the doctor who performed the examination/treatment. This avoids a psychological burden on the patient. The DGMP/DRG report suggests a relatively simple, clearly structured procedure with advantages for all parties involved (physician, medical physics experts, MTRA and patient).

Key points:

  • The DGMP/DRG report on prenatal radiation exposure describes the procedure for calculating radiation exposures and the associated risks for the unborn child.

  • Using the two-step model, only a simple assessment based on the first step is necessary for most prenatal radiation exposures.

  • With the given tables it is possible to estimate individual risks for the unborn child taking into account the radiation exposure.

  • Only in the rare case that the first estimate results in a uterine dose larger 20 mSv a more accurate calculation is necessary.

Citation Format

  • Fiebich M, Block A, Borowski M et al. Prenatal radiation exposure in diagnostic and interventional radiology. Fortschr Röntgenstr 2021; 193: 778 – 786

Publication History

Received: 08 June 2020

Accepted: 04 November 2020

Article published online:
16 December 2020

© 2020. Thieme. All rights reserved.

Georg Thieme Verlag KG
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