Iodinated Contrast Media in Pregnancy

In general, intravascular contrast media should be avoided in pregnancy, in order to avoid any possible hazard to the fetus. In vitro experiments have shown iodinated contrast to be mutagenic to human cells [1]. Reassuringly, animal studies have failed to show an in vivo teratogenic effect [2, 3]. The iodine content of contrast media has the potential to produce neonatal hypothyroidism, and this has been observed after the direct instillation of ionic contrast into the amniotic cavity during amniofetography [4]. The intravascular use of non-ionic contrast media has been reported to have no effect on neonatal thyroid function [5]. It is standard pediatric practice to screen all neonates for hypothyroidism, but it is particularly important to perform this test in the infants of mothers who received iodinated contrast during pregnancy [6].

Key point: Despite in vitro concerns, iodinated contrast seems safe to use in pregnancy.