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Answer to your Health Question

Title: X rays and pregnancy | TORCH test | Presence of IgG antibodies but not IgM antibodies

Question (posted on September 24, 2010) :

Hi,

I miscarried for twice before. (First time in June 2009, second time in November 2009)

First time there was no growth in the fetus, so had medical abortion as suggested by the doctor.

And second time, doctor said that the heartbeat of the fetus has stopped.

Undergone D & C second time.

Both miscarriages happened at the 3rd month of the pregnancy.

Now I am planning to get pregnant.

I recently consulted a gynecologist.

She suggested few tests, TORCH test, Thyroid test, antiphospholipid and antibodies test and normal blood tests.

All tests results are fine except the TORCH test and hemoglobin percentage.

It has written like Rubella Igg - positive, Rubella IGM - negative, Cytomegalovirus IgG - positive, Cytomegalovirus IgM - negative and hemoglobin percentage is 9.1.

Our gynecologist said those will not affect the pregnancy.

I am a bit nervous.

I am a dentist. I heard that exposing to X rays will affect the pregnancy. Is it true?

Could you please suggest?

What does the TORCH test report indicates.

Please suggest for a healthy pregnancy next time.

Thanks in advance.

Answer:

According to the American Academy of Family Physicians, x-rays are generally safe during pregnancy, but there is quite a bit of controversy surrounding this issue.

With dental x-rays there is hardly any exposure to any part of the body except the teeth.

X-ray examinations on the arms, legs, or chest do not expose your reproductive organs to the direct beam. However, x-rays of the torso, such as the abdomen, stomach, pelvis, lower back and kidneys, have a greater chance of exposure to the uterus.

According to the American College of Radiology, no single diagnostic x-ray has a radiation dose significant enough to cause adverse effects in a developing embryo or fetus. Some common diagnostic procedures include dental, chest, CT scan (head/chest), and abdominal view.

Ionizing radiation is the kind of electromagnetic radiation produced by x-ray machines, radioactive isotopes (radionuclides), and radiation therapy machines.

There is potential for the embryo or fetus to be exposed during the diagnostic or therapeutic procedures for women who are pregnant and have x rays, fluoroscopy, or radiation therapy or are administered liquid radioactive materials.

In the first two weeks post conception or the second two weeks from the last menstrual period, the embryo is very resistant to the malforming effects of x rays. The embryo is, however, sensitive to the lethal effects of x rays, although doses much higher than 5 rad or 50 mSv are necessary to cause a miscarriage.

From the third to the eighth week of pregnancy, the embryo is in the period of early embryonic development but is not affected with , either birth defects, pregnancy loss, or growth retardation unless the exposure is substantially above the 20 rad (200 mSv) exposure.

When a diagnostic x-ray study is of the head, teeth, chest, arms, neck, or legs at a qualified facility, the radiation exposure is not to the embryo or ovaries.

Diagnostic x-ray studies that may involve direct radiation exposure of the developing embryo include :

(a) X rays of the back (lumbar spine) for evaluating a lower back pain or a nerve route pain
(b) Intravenous pyelogram (IVP) to examine kidney function
(c) Upper GI series for evaluation of gastrointestinal symptoms
(d) Lower GI series (barium enema) to examine the structure and function of the large intestine
(e) X-ray studies of bladder function
(f) X-ray studies of the gallbladder and gallbladder function
(g) X-ray studies of the structure and function of the uterus and tubes with the procedure known as a hysterosalpingogram (HSP)
(h) X-ray studies of the pelvis and hips due to hip pain, and
(i) standard abdominal x rays.

Regardless of the dose received from these procedures, each woman must realize that when she begins a pregnancy she has a reproductive risk (referred to as background risks) of 3 percent for major birth defects and 15 percent for miscarriage. These risks change depending on the family history of the mother and her own reproductive history.

The TORCH test measures the presence of antibodies (protein molecules produced by the human immune system in response to a specific disease agent) and their level of concentration in the blood.

The name of the test comes from the initial letters of the five disease categories:

Toxoplasmosis
Other (syphilis)
Rubella
Cytomegalovirus (CMV)
Herpes simplex virus (HSV)

A TORCH test, also known as the TORCH panel, determines whether you have any infectious disease in your body as well as the concentration level of the virus in your blood stream.

Being an initial level test, the TORCH panel can let you know if you have an occurrence of a past infection, an on-going infection, or whether you have never been exposed to the infection at all.

Hence, after this test is done, if the results are positive, then you will be asked to take particular tests to be doubly sure you have that infection.

The TORCH test specifically detects the following infections:

* Toxoplasma
* Rubella
* Cytomegalovirus
* Herpes

Apart from that, this test can also detect infections like syphilis and hepatitis B.

Rubella, also known as the German Measles, is typically a childhood disease that is mild. However, in pregnancy, when the mother has rubella, there are a number of problems that may occur.

If you have rubella in the first trimester, you have about a 25% risk of having a birth defect, known as congenital rubella syndrome. The defects can include:

* Heart deformities
* hearing loss
* Mental retardation
* Eye deformities
* Others

The presence of IgG antibodies but not IgM antibodies indicates a history of past exposure to the virus or vaccination and indicates that the person tested should be immune to the rubella virus.



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