Vq test in pregnancy - any radiologist/docs give opinion ?

[Lkakpk]

So I am 32 weeks pregnant and currently low on iron at 96 . Unable to tolerate tabs so was on triage on Mat unit this week to organise iron transfusion . Whilst there I was examined by doc and mentioned as well as been lethargic and run down I had pain upon breathing in and short of breath . Doctor instantly worried about pulmonary embolism . I explained I had chest pain on and off all pregnancy but he was still very concerned .
i had ecg which was normal , normal echo and am now being persuaded to have a vq scan after I adamantly refused a cpa scan with the breast cancer risk .
im so concerned , my gut feeling is it could be due to reflux or my anemia or just from getting bigger but doctors won’t accept this and are pushing for this scan .can anyone make me feel better about the childhood cancer risk to my unborn baby and also the risk to myself of breast cancer? . I’m so conflicted . A doctor said today it’s highly unlikely it will be a clot due to my positive test results but they still want me to have it and I’m terrified … can anyone reassure me or confirm the risk and implications from the radiation ? Please be honest and give your true opinion ?

I’m a nurse
I have also had three babies
if they want you to have the scan the risk of clot is higher than any radiation risk. Clots can kill you.

@ChristmasAtHogwarts Thankyou for replying . I feel it prob isn’t a clot though , and I feel they are just being extra cautious . I’m just worried about radiation risk ?

As someone mentioned above it’s part of the process when someone is referred for an examination with ionising radiation that the potential benefits must outweigh the risks. The radiation dose to your baby from both examinations is very low, especially when considered against the baseline risk of childhood cancer which is about 1 in 500 in the UK. VQ scans have a smaller radiation dose than CTPA examinations so the risk to your baby will be even lower still.

I say this as someone working in this field but also a mother who has had a number of CTPA and X-rays during my most recent pregnancy. I was not concerned about the radiation risks at all, and if you would like any further information to allay your fears please just let me know. Hope you’re feeling ok and that the rest of your pregnancy is plain sailing!

I’m a nurse and had one of these in my last pregnancy despite being almost certain I didn’t have a clot.
they are commonly done on pregnant ladies because of the lower radiation than other types of scan.
I didn’t have a clot and baby was fine!

@AlphaBetaZeta Thankyou so much for this . My main worry is obviously the childhood cancer risk but also the breast cancer risk ? Do you have any facts on this as it seems a bit mixed online . Also worried as I’ve also had head mri this pregnancy and obviously a chest X-ray prior to this vq

@tigerbread20 what were your symptoms ? Thankyou for reassurance x

I had a clot in pregnancy and nearly died. Have the scan.

I used to work in Nuclear Medicine. It's such a low level of radiation. The risks of a PE clot far outweigh the risk to you or your baby from the tiny bit of radionuclide you're injected with. Trust your doctor.

Most pregnant ladies who had VQ scans didn't have PE by the way. Organs move about during pregnancy which can cause breathlessness and that's usually been the case we've seen.

You feel it isn't a clot, your doctor is concerned enough to send you for a scan. Get the scan. They wouldn't recommend it if there were huge risks

@Mabelstearooms Thankyou so much for the reassurance . Can you give me any further info on breast cancer risk and childhood cancer ? It seems a bit varied online ?

@takemetomybeach wow glad you are ok !

Breathlessness and vague chest pain, all positional in the end (baby/moved organs!)

@tigerbread20 seems similar to me !

I'm not pregnant but had one recently as my DDimmer blood test suggested a clot and I'm breathless etc.

What they didnt warn me was you need to lie still for 10mins in the machine with a mask over your face which I found made breathing a little harder. Now I've done it I would be fine doing it again but I'd have rather had the warning as it's an odd sensation!

They've decided its a chest infection (despite clear chest xray/no crackling on chest) so I really hope they're right after I've been anxious about the clot!

@SunflowerOrange thanks for the heads up !

I was in a similar situation to you. I had a bad cold that left me with a cough I couldn't shift. Had a bit of pain taking a deep breath and breathlessness but as I was coughing so much and was 30 weeks pregnant I presumed it was because of that. In the end the doctor talked me into the scan by telling me the radiation level was the equivalent as a short haul flight and it turned out I had multiple clots and was lucky to be alive. When clots were suspected in a later pregnancy I didn't hesitate in having the scan.

@WilsonandNoodles Thankyou for this !

@Lkakpk the additional risk of breast cancer from the VQ scan is orders of magnitude lower than the baseline breast cancer risk (1 in 7 for women in the UK) so that wouldn’t stop me from getting the scan.

As for your other imaging, chest X-rays are associated with only a tiny radiation dose to you, and much less to baby, and MRI does not use ionising radiation so there is no associated risk there.

I feel it’s also important to point out that no one knows what happens at low radiation doses, as there’s only a known link between cancer induction and ionising radiation exposure at doses much higher than most diagnostic imaging exams. Some people even believe that low doses of radiation actually protect from cancer (hormesis), but in medicine and radiation protection we apply a precautionary approach to ensure the lowest dose of radiation and therefore lowest theoretical risk of cancer induction is used.

@AlphaBetaZeta Thankyou for this . Would you recommend avoiding my 4 year old following the scan ? I’ve seen mixed online ..

@AlphaBetaZeta also I’ve read due to more sensitive breast tissue it can make cells react ? Is this true or more so for other scan ?

I feel your anxiety but honestly the doses are so low this step would not be needed.

Have you talked to anyone about how anxious you are?

@LadyCampanulaTottington I did , I spoke to consultant but to be honest she was not really too reassuring regarding the risks she was very matter of fact about the increased risks of childhood cancer and breast cancer . Which didn’t make me feel any better atall in all honesty ! I think what makes me so anxious is my gut tells me it probably isn’t pe … I think if I was really unwell I would feel better about it if that makes sense ?!

@Lkakpk maybe ask to speak to the radiologist for some reassurance?

You can’t be 100% sure it’s not a PE and that is life threatening if it is. The risk from the scan is much less but I understand your anxiety around to. It feels like a no win situation I’m sure.

@LadyCampanulaTottington Thankyou I appreciate the reassurance . I will ask to speak to radiologist

No, I wouldn’t recommend that you avoid your 4 year old after the scan, there’s no need to. It’s true that breast tissue is more radiosensitive than some other organs in the body, but it’s all relative. The radiation dose you will receive from this examination is minimal and would definitively rule out presence of PE.

You’re obviously feeling anxious and I would gently suggest that searching around for information only might not be helpful, particularly since the risks are only theoretical and in many cases the doses discussed online are much greater than I would expect to see used in the UK.

Ultimately you need to do what you feel comfortable with but I only wish that PE could be diagnosed with a feeling - would free up a lot of time on our SPECT CT scanners!