Learning Objectives and CME/Disclosure Information
This activity is intended for healthcare providers delivering care to women and their families.
After completing this activity, the participant should be better able to:
1. Recall when CT scan is appropriate in pregnancy 2. Choose appropriate imaging when pulmonary embolus is suspected
Estimated time to complete activity: 0.25 hours
Susan J. Gross, MD, FRCSC, FACOG, FACMG President and CEO, The ObG Project
Disclosure of Conflicts of Interest
Postgraduate Institute for Medicine (PIM) requires faculty, planners, and others in control of educational content to disclose all their financial relationships with ineligible companies. All identified conflicts of interest (COI) are thoroughly vetted and mitigated according to PIM policy. PIM is committed to providing its learners with high quality accredited continuing education activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of an ineligible company.
The PIM planners and others have nothing to disclose. The OBG Project planners and others have nothing to disclose.
Faculty: Susan J. Gross, MD, receives consulting fees from Cradle Genomics, and has financial interest in The ObG Project, Inc.
Planners and Managers: The PIM planners and managers, Trace Hutchison, PharmD, Samantha Mattiucci, PharmD, CHCP, Judi Smelker-Mitchek, MBA, MSN, RN, and Jan Schultz, MSN, RN, CHCP have nothing to disclose.
Method of Participation and Request for Credit
Fees for participating and receiving CME credit for this activity are as posted on The ObG Project website. During the period from Dec 31 2017 through Dec 31 2018, participants must read the learning objectives and faculty disclosures and study the educational activity.
If you wish to receive acknowledgment for completing this activity, please complete the post-test and evaluation. Upon registering and successfully completing the post-test with a score of 100% and the activity evaluation, your certificate will be made available immediately.
For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service within 4 weeks.
Joint Accreditation Statement
In support of improving patient care, this activity has been planned and implemented by the Postgraduate Institute for Medicine and The ObG Project. Postgraduate Institute for Medicine is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.
Physician Continuing Medical Education
Postgraduate Institute for Medicine designates this enduring material for a maximum of 0.25 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Continuing Nursing Education
The maximum number of hours awarded for this Continuing Nursing Education activity is 0.2 contact hours.
If a CT (computed tomography) scan is being considered or has been ordered and the patient is pregnant, consider the following questions
Would a CT be ordered if the patient was not pregnant?
If the answer to the above is ‘yes’
Is there another option available that would provide the equivalent information on which to base management?
Consider an MRI, which is a safe alternative to CT imaging in cases where they are equivalent for the diagnosis in question
If no, and there is not an equal or better alternative
CT scan should be performed
Do not withhold associated contrast material if clinically indicated
In addition to a discussion of the risks and benefits with the patient, there are additional resources that can be accessed if necessary, including
Genetic counseling services
Clinical physicists: some centers have these individuals on staff and they can assist in calculating actual radiation dose and risks associated with exposure in pregnancy
The radiation exposure in pregnancy from CT procedures varies depending on the number and spacing of adjacent imaging sections. It is very unusual for a patient to be exposed to sufficient radiation to cause any significant adverse events. Clinically documented intellectual disability requires at least 610 mGy and growth restriction and anomalies have been reported at levels greater than 50mGy.
Fetal Radiation Dose and CT Exam Type
Very low-dose exam: 0.1 mGy
Low- to moderate-dose exam: 0.1-10 mGy
Higher-dose exam: 10-50 mGy
Type of CT Exam
Head or neck CT (very low-dose)
Chest CT or CT pulmonary angiography (low- to moderate-dose)
Limited CT pelvimetry (low- to moderate-dose)
Abdominal CT (higher-dose)
A CT evaluation of the chest results in a lower dose of fetal exposure to radiation compared with ventilation perfusion scanning
Radiation exposure from a spiral CT is comparable to conventional CT
The most commonly used contrast material is an iodinated media which carries a low risk of adverse effects
Should be used only if absolutely required to obtain additional diagnostic information
Breastfeeding can be continued after the use of iodinated contrast material
OBG Project CME requires a modern web browser (Internet Explorer 10+, Mozilla Firefox, Apple Safari, Google Chrome, Microsoft Edge). Certain educational activities may require additional software to view multimedia, presentation, or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Adobe Flash, Apple QuickTime, Adobe Acrobat, Microsoft PowerPoint, Windows Media Player, or Real Networks Real One Player.
Disclosure of Unlabeled Use
This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. The planners of this activity do not recommend the use of any agent outside of the labeled indications.
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of the planners. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications, and warnings.
Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information
presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient’s conditions and possible contraindications and/or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities.
Jointly provided by
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