nach oben

Erschienen in:

01.08.2014 | Radiological Education

Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy

verfasst von: Maria Assunta Cova, Fulvio Stacul, Roberto Quaranta, Pierpaolo Guastalla, Guglielmo Salvatori, Giuseppe Banderali, Claudio Fonda, Vincenzo David, Massimo Gregori, Antonio Alberto Zuppa, Riccardo Davanzo

Erschienen in: European Radiology | Ausgabe 8/2014

Einloggen, um Zugang zu erhalten

Abstract

Objectives

Breastfeeding is a well-recognised investment in the health of the mother-infant dyad. Nevertheless, many professionals still advise breastfeeding mothers to temporarily discontinue breastfeeding after contrast media imaging. Therefore, we performed this review to provide health professionals with basic knowledge and skills for appropriate use of contrast media.

Methods

A joint working group of the Italian Society of Radiology (SIRM), Italian Society of Paediatrics (SIP), Italian Society of Neonatology (SIN) and Task Force on Breastfeeding, Ministry of Health, Italy prepared a review of the relevant medical literature on the safety profile of contrast media for the nursing infant/child.

Results

Breastfeeding is safe for the nursing infant of any post-conceptional age after administration of the majority of radiological contrast media to the mother; only gadolinium-based agents considered at high risk of nephrogenic systemic fibrosis (gadopentetate dimeglumine, gadodiamide, gadoversetamide) should be avoided in the breastfeeding woman as a precaution; there is no need to temporarily discontinue breastfeeding or to express and discard breast milk following the administration of contrast media assessed as compatible with breastfeeding.

Conclusions

Breastfeeding women should receive unambiguous professional advice and clear encouragement to continue breastfeeding after imaging with the compatible contrast media.

Key Points:

• Breastfeeding is a well-known investment in the health of the mother-infant dyad.

• Breastfeeding is safe after administration of contrast media to the mother.

• There is no need to temporarily discontinue breastfeeding following administration of contrast media.

Crownover BK, Bepko JL (2013) Appropriate and safe use of diagnostic imaging. Am Fam Physician 87:494–501PubMed

Wang PI, Chong ST, Kielar AZ et al (2012) Imaging of pregnant and lactating patients: part 1, evidence-based review and recommendations. AJR Am J Roentgenol 198:778–784PubMedCrossRef

Frohlich JM, Kubik-Huch RA (2013) Radiographic, MR or ultrasound contrast media in pregnant or breast-feeding women: what are the key issues? Röfo 185:13–25PubMed

World Health Organization (2009) Acceptable medical reasons for use of breast-milk substitutes. World Health Organization, Geneva. Available via http://www.who.int/nutrition/publications/infantfeeding/WHO_NMH_NHD_09.01/en/. Accessed 22 Sept 2013

American Academy of Pediatrics Section on Breastfeeding (2012) Breastfeeding and the use of human milk. Pediatrics 129:e827–e841CrossRef

Robinson S, Fall C (2012) Infant nutrition and later health: a review of current evidence. Nutrients 4:859–874PubMedCentralPubMedCrossRef

Varalda A, Coscia A, Di Nicola P et al (2012) Medication and breastfeeding. J Biol Regul Homeost Agents 26:1–4PubMed

Berlin CM Jr, van den Anker JN (2013) Safety during breastfeeding: drugs, foods, environmental chemicals, and maternal infections. Semin Fetal Neonatal Med 18:13–18PubMedCrossRef

Available via http://toxnet.nlm.nih.gov/. Accessed 2 Feb 2014

10.

Davanzo R, Rubert L, Oretti C (2008) Meta-variability of advice on drugs in the breastfeeding mother: the example of beta-blockers. Arch Dis Child Fetal Neonatal Ed 93:F249–F250PubMedCrossRef

11.

Hale TW (2012) Medications and mothers’ milk 2012, 15th edn. Hale Publishing, Amarillo

12.

Wilson JT, Brown RD, Cherek DR et al (1980) Drug excretion in human breast milk: principles, pharmacokinetics and projected consequences. Clin Pharmacokinet 5:1–66PubMedCrossRef

13.

European Society of Urogenital Radiology (2013) ESUR Guidelines on Contrast Media version 8.1. Available via http://www.esur.org/esur-guidelines/. Accessed 22 Sept 2013

14.

14 SonoVue: EPAR-Product Information. Available via http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000303/WC500055380.pdf. Accessed 22 Sept 2013

15.

15 Optison: EPAR-Product Information. Available via http://www.ema.europa.eu/docs/en_GB/document_library/EPAR_-_Product_Information/human/000166/WC500059461.pdf. Accessed 22 Sept 2013

16.

16 American College of Radiology (2013) ACR manual on contrast media, version 9. Available via http://www.acr.org/quality-safety/resources/contrast-manual. Accessed 22 Sept 2013

17.

17 The Royal Australian and New Zealand College of Radiologists (2009) RANZCR guidelines for iodinated contrast administration. Available via http://www.ranzcr.edu.au/quality-a-safety/resources/guidelines. Accessed 22 Sept 2013

18.

18 The Royal Australian and New Zealand College of Radiologists (2007) RANZCR MRI safety guidelines. Available via http://www.ranzcr.edu.au/quality-a-safety/resources/guidelines. Accessed 22 Sept 2013

19.

Webb JAW (2014) Pregnancy and lactation. In: Thomsen HS, Webb JAW (eds) Contrast media: safety issues and ESUR guidelines, 3rd edn. Springer, Berlin Heidelberg

20.

Bourrinet P, Dencausse A, Havard P, Violas X, Bonnemain B (1995) Transplacental passage and milk excretion of iobitridol. Invest Radiol 30:156–158PubMedCrossRef

21.

FitzJohn TP, Williams DG, Laker MF, Owen JP (1982) Intravenous urography during lactation. Br J Radiol 55:603–605PubMedCrossRef

22.

Texier F, Roque d'Orbcastel O, Etling N (1983) Stable iodine level in human milk after pulmonary angiography. Presse Med 12:769PubMed

23.

Nielsen ST, Matheson I, Rasmussen JN, Skinnemoen K, Andrew E, Hafsahl G (1987) Excretion of iohexol and metrizoate in human breast milk. Acta Radiol 28:523–526PubMedCrossRef

24.

Ilett KF, Hackett LP, Paterson JW, McCormick CC (1981) Excretion of metrizamide in milk. Br J Radiol 54:537–538PubMedCrossRef

25.

Holmdahl KH (1956) Cholecystography during lactation. Acta Radiol 45:305–307PubMedCrossRef

26.

Johansen JG (1978) Assessment of a non-ionic contrast medium (Amipaque) in the gastrointestinal tract. Invest Radiol 13:523–527PubMedCrossRef

27.

Okazaki O, Murayama N, Masubuchi N, Nomura H, Hakusui H (1996) Placental transfer and milk secretion of gadodiamide injection in rats. Arzneimittelforschung 46:83–86PubMed

28.

Kubik-Huch RA, Gottstein-Aalame NM, Frenzel T et al (2000) Gadopentetate dimeglumine excretion into human breast milk during lactation. Radiology 216:555–558PubMedCrossRef

29.

Schmiedl U, Maravilla KR, Gerlach R, Dowling CA (1990) Excretion of gadopentetate dimeglumine in human breast milk. AJR Am J Roentgenol 154:1305–1306PubMedCrossRef

30.

Rofsky NM, Weinreb JC, Litt AW (1993) Quantitative analysis of gadopentetate dimeglumine excreted in breast milk. J Magn Reson Imaging 3:131–132PubMedCrossRef

31.

Kaminsky S, Laniado M, Gogoll M et al (1991) Gadopentetate dimeglumine as a bowel contrast agent: safety and efficacy. Radiology 178:503–508PubMed

32.

Laniado M, Kornmesser W, Hamm B, Clauss W, Weinmann HJ, Felix R (1988) MR imaging of the gastrointestinal tract: value of Gd-DTPA. AJR Am J Roentgenol 150:817–821PubMedCrossRef

33.

Idee JM, Port M, Raynal I, Schaefer M, Le Greneur S, Corot C (2006) Clinical and biological consequences of transmetallation induced by contrast agents for magnetic resonance imaging: a review. Fundam Clin Pharmacol 20:563–576PubMedCrossRef

34.

Tweedle MF, Wedeking P, Kumar K (1995) Biodistribution of radiolabeled, formulated gadopentetate, gadoteridol, gadoterate, and gadodiamide in mice and rats. Invest Radiol 30:372–380PubMedCrossRef

35.

White GW, Gibby WA, Tweedle MF (2006) Comparison of Gd(DTPA-BMA) (Omniscan) versus Gd(HP-DO3A) (ProHance) relative to gadolinium retention in human bone tissue by inductively coupled plasma mass spectroscopy. Invest Radiol 41:272–278PubMedCrossRef

36.

Abraham JL, Thakral C (2008) Tissue distribution and kinetics of gadolinium and nephrogenic systemic fibrosis. Eur J Radiol 66:200–207PubMedCrossRef

37.

Webb JAW, Thomsen HS (2013) Gadolinium contrast media during pregnancy and lactation. Acta Radiol 54:599–600PubMedCrossRef

38.

Claudon M, Dietrich CF, Choi BI et al (2013) Guidelines and good clinical practice recommendations for Contrast Enhanced Ultrasound (CEUS) in the liver—update 2012: A WFUMB-EFSUMB initiative in cooperation with representatives of AFSUMB, AIUM, ASUM, FLAUS and ICUS. Ultrasound Med Biol 39:187–210PubMedCrossRef

39.

Senthilnathan S, Gauvreau K, Marshall AC, Lock JE, Bergersen L (2009) Contrast administration in pediatric cardiac catheterization: dose and adverse events. Catheter Cardiovasc Interv 73:814–820PubMedCrossRef

40.

Frush DP, Herlong JR (2005) Pediatric thoracic CT angiography. Pediatr Radiol 35:11–25PubMedCrossRef

41.

Callahan MJ, Poznauskis L, Zurakowski D, Taylor GA (2009) Nonionic iodinated intravenous contrast material-related reactions: incidence in large urban children's hospital—retrospective analysis of data in 12,494 patients. Radiology 250:674–681PubMedCrossRef

42.

European Medicines Agency makes recommendations to minimise risk of nephrogenic systemic fibrosis with gadolinium-containing contrast agents. EMEA/CHMP/739818/2009. Available via http://www.ema.europa.eu/ema/index.jsp?curl=pages/includes/document/document_detail.jsp?webContentId=WC500015569&mid=WC0b01ac058009a3dc

43.

Thomsen HS, Morcos SK, Almen T et al (2013) Nephrogenic systemic fibrosis and gadolinium-based contrast media: updated ESUR Contrast Medium Safety Committee guidelines. Eur Radiol 23:307–318PubMedCrossRef

44.

Bernstein EJ, Schmidt-Lauber C, Kay J (2012) Nephrogenic systemic fibrosis: a systemic fibrosing disease resulting from gadolinium exposure. Best Pract Res Clin Rheumatol 26:489–503PubMedCrossRef

45.

Nardone B, Saddleton E, Laumann AE et al (2014) Pediatric nephrogenic systemic fibrosis is rarely reported: a RADAR report. Pediatr Radiol 44:173–180PubMedCrossRef

46.

Schneider G, Schurholz H, Kirchin MA, Bucker A, Fries P (2013) Safety and adverse effects during 24 hours after contrast-enhanced MRI with gadobenate dimeglumine (MultiHance) in children. Pediatr Radiol 43:202–211PubMedCrossRef

47.

Dillman JR, Ellis JH, Cohan RH, Strouse PJ, Jan SC (2007) Frequency and severity of acute allergic-like reactions to gadolinium-containing i.v. contrast media in children and adults. AJR Am J Roentgenol 189:1533–1538PubMedCrossRef

48.

Singh N, McLean K (2012) Five things to know about…: intravascular contrast media for imaging in breastfeeding women. CMAJ 184:E775PubMedCentralPubMedCrossRef

49.

Hylton NM (2000) Suspension of breast-feeding following gadopentetate dimeglumine administration. Radiology 216:325–326PubMedCrossRef

50.

Chen MM, Coakley FV, Kaimal A, Laros RK Jr (2008) Guidelines for computed tomography and magnetic resonance imaging use during pregnancy and lactation. Obstet Gynecol 112:333–340PubMedCrossRef

51.

Webb JA, Thomsen HS, Morcos SK (2005) The use of iodinated and gadolinium contrast media during pregnancy and lactation. Eur Radiol 15:1234–1240PubMedCrossRef

52.

Tremblay E, Therasse E, Thomassin-Naggara I, Trop I (2012) Quality initiatives: guidelines for use of medical imaging during pregnancy and lactation. Radiographics 32:897–911PubMedCrossRef

53.

Sachs HC (2013) The transfer of drugs and therapeutics into human breast milk: an update on selected topics. Pediatrics 132:e796–e809PubMedCrossRef

Titel: Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy
verfasst von: Maria Assunta Cova
Fulvio Stacul
Roberto Quaranta
Pierpaolo Guastalla
Guglielmo Salvatori
Giuseppe Banderali
Claudio Fonda
Vincenzo David
Massimo Gregori
Antonio Alberto Zuppa
Riccardo Davanzo
Publikationsdatum: 01.08.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 8/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3198-6

Neu im Fachgebiet Radiologie

18.04.2024 | Pädiatrische Notfallmedizin | Nachrichten

Update Radiologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Radiological contrast media in the breastfeeding woman: a position paper of the Italian Society of Radiology (SIRM), the Italian Society of Paediatrics (SIP), the Italian Society of Neonatology (SIN) and the Task Force on Breastfeeding, Ministry of Health, Italy

Abstract

Objectives

Methods

Results

Conclusions

Key Points:

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie

Springer Medizin

Abstract

Objectives

Methods

Results

Conclusions

Key Points:

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 8/2014

Imaging findings in a distinct lethal inherited arteriopathy syndrome associated with a novel mutation in the FBLN4 gene

A novel removable shield attached to C-arm units against scattered X-rays from a patient’s side

MR imaging of myxofibrosarcoma and undifferentiated sarcoma with emphasis on tail sign; diagnostic and prognostic value

Computer-aided evaluation as an adjunct to revised BI-RADS Atlas: improvement in positive predictive value at screening breast MRI

Abdominal aortic aneurysm calcification and thrombus volume are not associated with outcome following endovascular abdominal aortic aneurysm repair

The value of diffusion-weighted imaging in the detection of prostate cancer: a meta-analysis

Neu im Fachgebiet Radiologie

Fünf Dinge, die im Kindernotfall besser zu unterlassen sind

Wie toxische Männlichkeit der Gesundheit von Männern schadet

Studie bestätigt Potenzial von KI in der Radiologie

Quantitative Angiografie könnte IVUS-Alternative darstellen

Update Radiologie