Reactions to contrast agents are uncommon but range from mild urticaria to life threatening anaphylactic reactions. Majority of these reactions occur due to intravenous administration of iodinated contrast media. Acute reactions to MRI gadolinium-based contrast are much less common but they do occur and thus have to be managed. Usual presentations include urticaria, nausea, vomiting, angioedema, bronchospasm, laryngospasm and systemic hypotension. Majority of these reactions occur within the first twenty minutes after administration of contrast. Therefore, their recognition and prompt treatment are critical for good patient outcome. Attendant to this the radiology department must be adequately prepared to handle these emergencies as and when they do occur. This means an up to date emergency tray must be checked regularly before the start of the procedure, ensure there is epinephrine, antihistamines, beta-2-agonists metered dose inhalers, IV fluids, and ready supply of oxygen. Close collaboration of radiology staff with the hospital emergency response team is critical since severe reactions will need the intervention of this team.
Part of the book: Recent Advances in Asthma Research and Treatments
Congenital fetal anomalies contribute to the global burden of disease in children. Various screening programs have been used for antenatal screening of these anomalies. Screening targets low risk population and is usually done in the second trimester though some are done at the mother’s first antenatal visit especially in resource constrained setting. Mother’s who have had a previous pregnancy with congenital anomaly are given targeted elaborate screening. Early diagnosis of this anomalies can lead to early intervention and better outcomes. Diagnosis of the malformations also leads to clinical decision making on mode of delivery thereby avoiding birth related trauma to the mother and the baby. In case of lethal congenital anomalies early diagnosis aids in clinical decision making on the management of the pregnancy.
Part of the book: Empowering Midwives and Obstetric Nurses