The use of MR contrast media in pregnant women and small children

In general, at most institutions pregnancy has been a contraindication for giving gadolinium-containing contrast media based the principle of not exposing the fetus to drugs and the unknown teratogen risk to the fetus. However, when reviewing the literature there is no evidence that gadolinium agents cause chromosomal damage or teratogen effect (1-4). There are no reports in the literature on negative effects on the fetus or neonate after the administration of gadolinium-containing contrast media to the pregnant or breast-feeding mothers (2). Based on guidelines from institutions in Europe gadolinium contrast media to pregnant women is considered safe. However in the choice between different contrast media it has been recommended to use those gadolinium agents that have been on the market the longest due to the overall longer experience with these contrast media compared to more recent developed contrast media (2). MRI is to be preferred over CT due to the radiation given both to the mother and the fetus when using CT. Therefore, in the decision making to give or not give intravenous gadoliniumcontaining contrast media to pregnant women has to be based on the medical indication. There is no reason to give intravenous contrast media if the examination can be performed without but if indicated there is no reason to not use intravenous contrast media to answer the clinical question on hand. In pregnant women and breast feeding mothers with reduced kidney function the same restrictions for the use of gadolinium-containing contrast media has apply as for others with reduced kidney function to reduce the risk for NSF.