SIR 2024
Women's Health
Akhilesh Pillai (he/him/his)
Medical Student
McGovern Medical School UTHealth Houston
Financial relationships: Full list of relationships is listed on the CME information page.
The purpose of this exhibit is to highlight the unique circumstance of the pregnant patient undergoing consideration for an IR procedure. We wish to highlight peri-procedural considerations from the viewpoint of the multiple disciplines involved such as obstetrics, anesthesia and perinatal care. In addition, we will review procedural practices that can help maximize safety for the pregnant patient.
Background:
IR consultation for the pregnant patient requires balancing risk/benefit for two individuals: the sick mother and the developing fetus. A multidisciplinary approach is key to optimizing the peri-procedural care and providing safe outcomes. Knowledge and familiarity with aspects of maternal and fetal monitoring, anesthetic considerations, teratogenic risk for common medications used in IR, and radiation safety will help the proceduralist maximize safety for both the mother and her child.
Clinical Findings/Procedure Details:
Peri-procedural considerations from the obstetric, anesthesia and peri-natal viewpoints are reviewed including procedure timing, maternal-fetal monitoring, aspiration/antibacterial/VTE prophylaxis, and risk mitigation for pre-term labor. Radiation safety optimization and relevant parameters are reviewed. Risk profile for common IR medications as well as analgesic optimization strategies are discussed – including role of nerve blocks / regional interventions in applicable situations which can help reduce total systemic analgesic dose in the peri and post-operative period.
Conclusion and/or Teaching Points:
The pregnant patient presents a unique challenge to the interventional radiologist where one has to balance the risk/benefit for both the mother and the fetus. Understanding the peri-procedural care of the pregnant patient from the lens of the obstetrician, anesthesiologist, and peri-natal care will help the interventional radiologist in achieving safe and successful outcomes. Awareness of medication safety profiles and utilization of regional therapy such as nerve blocks in applicable situations can help optimize peri-operative analgesia for the pregnant patient.