Pregnant woman in the area of ionizing radiation

Uvod: V času nosečnosti imajo prednost preiskave, pri katerih ni škodljivega ionizirajočega sevanja. To sta, predvsem, ultrazvok (UZ) in magnetna resonanca (MR). Obe, po doslej znanih podatkih, nimata neposredno dokazanih škodljivih učinkov na plod. UZ lahko varno uporabljamo ves čas nosečnosti, medtem ko MR uporabljamo takrat, ko se pojavi sum na patologijo praviloma po prvem tromesečju. Kadar so za diagnostiko sumljivih sprememb ali zamejitev bolezni potrebne preiskave, ki uporabljajo ionizirajoče sevanje, moramo skrbno pretehtati ali njihova uporaba upravičuje tveganje zaradi morebitnih okvar ploda. Razlikujemo med preiskavami, pri katerih je doza sevanja majhna in so razmeroma varne, kot je klasično rentgensko slikanje, če so doze pod mejnimi dozami in preiskavami, pri katerih je doza sevanja večja, kot je računalniška tomografija (CT). Namen: Namen diplomskega dela je na podlagi sistematičnega pregleda literature opisati mejne doze ionizirajočega sevanja, ki jih prejmejo nosečnice kot pacientke in delavke in učinke ter tveganja le-teh za plod. Naš cilj je pridobiti bolje razumevanje o tveganju in posledicah ionizirajočega sevanja na plod pri izpostavljenih pacientkah, kot tudi smernicah za zmanjšanje doz in učinkov na noseče poklicno izpostavljene ženske. Metode dela: Pri izdelavi diplomske naloge smo pregledali ustrezno literaturo in za predstavitev rezultatov uporabili deskriptivno metodo. Literaturo smo zbirali od oktobra 2021 do marca 2022, na različnih podatkovnih bazah, predvsem v angleščini. Viri so večinoma znanstveni in strokovni članki, ki so dostopni v elektronski obliki. Rezultati: Ugotovili smo, da so učinki in tveganja ionizirajočega sevanja na noseče pacientke odvisni od časa izpostavljenosti, gestacijske starosti in radiološke preiskave. Doze, manjše od 50 mGy ne predstavljajo tveganje za nepravilnosti, se štejejo za zanemarljive v primerjavi z izhodiščnimi tveganji za vse razvojne nepravilnosti Kar se tiče poklicne izpostavljenosti, na radiološkem oddelku noseča delavka lahko nadaljuje z delom pod pogojem, da doza ploda med celotno nosečnostjo ne presega 1 mSv. Razprava in zaključek: Med glavnimi učinki ionizirajočega sevanja na plod, večina avtorjev navaja intrauterino smrt, malformacije in upočasnitev rasti v svojih člankih. Glede na rezultate vključenih člankov je pri nosečih delavkah 1 mSv doza na plod, katero se ne bi smelo preseči v nosečnosti. S tem je podprta uporaba določenih tehnik in pravil za optimizacijo in omejitev doze v delovnem okolju.Introduction: Investigations in which there is no harmful ionizing radiation are preferred during pregnancy. These are, in particular, ultrasound (US) and magnetic resonance imaging (MR). Both, according to the data known so far, have no directly proven harmful effects on the fetus and can be used safely throughout pregnancy. Where tests using ionizing radiation are necessary to diagnose suspicious changes or to limit disease, careful consideration should be given to whether their use justifies the risk of possible fetal damage. A distinction is made between examinations in which the radiation dose is low and relatively safe, such as classical X-ray imaging, and examinations in which the radiation dose is higher than computed tomography (CT). Purpose: The purpose of the diploma thesis is to describe the limit doses of ionizing radiation received by pregnant women and the effects and their risks to the fetus, based on a systematic review of the literature. Our goal is to gain a better understanding of the risks and consequences of ionizing radiation on the fetus in exposed patients, as well as guidelines for reducing doses and effects on pregnant occupational exposed women. Methods: When preparing the diploma thesis, we reviewed the relevant literature and used a descriptive method to present the results. Literature was collected from October 2021 to November 2021, mostly in English. Sources are mostly scientific and professional articles that are available in electronic form. Results: After limiting the articles with different inclusion and exclusion criteria, we included 14 articles in the joint literature review, from which we extracted key findings. Discussion and conclusion: We found that the effects and risks of ionizing radiation on pregnant patients depend on the time of exposure, gestational age, and radiological examination. Doses less than 50 mGy do not pose a risk of abnormalities are considered negligible compared to baseline risks for all developmental abnormalities. As far as occupational exposure is concerned, a pregnant worker in the radiology department may continue to work provided that the fetal dose does not exceed 1 mSv during the entire pregnancy