Abstract/Text: Thousands of pregnant patients and radiation workers are exposed to ionising radiation each year. Lack of knowledge is responsible for great anxiety and probably unnecessary termination of pregnancies. For many patients, the exposure is appropriate, while for others the exposure may be inappropriate, placing the unborn child at increased risk. Prenatal doses from most properly done diagnostic procedures present no measurably increased risk of prenatal death, malformation, or impairment of mental development over the background incidence of these entities. Higher doses, such as those involved in therapeutic procedures, can result in significant fetal harm. The pregnant patient or worker has a right to know the magnitude and type of potential radiation effects that might result from in utero exposure. Almost always, if a diagnostic radiology examination is medically indicated, the risk to the mother of not doing the procedure is greater than is the risk of potential harm to the fetus. Most nuclear medicine procedures do not cause large fetal doses. However, some radiopharmaceuticals that are used in nuclear medicine can pose significant fetal risks. It is important to ascertain whether a female patient is pregnant prior to radiotherapy. In pregnant patients, cancers that are remote from the pelvis usually can be heated with radiotherapy. This however requires careful planning. Cancers in the pelvis cannot be adequately treated during pregnancy without severe or lethal consequences for the fetus. The basis for the control of the occupational exposure of women who are not pregnant is the same as that for men. However, if a woman is, or may be, pregnant, additional controls have to be considered to protect the unborn child. In many countries, radiation exposure of pregnant females in biomedical research is not specifically prohibited. However, their involvement in such research is very rare and should be discouraged. Termination of pregnancy is an individual decision affected by many factors. Fetal doses below 100 mGy should not be considered a reason for terminating a pregnancy. At fetal doses above this level, informed decisions should be made based upon individual circumstances.

Abstract/Text: OBJECTIVE: One of the populations most exposed to chronic low-dose radiation from Chornobyl (Chernobyl in Russian) lives in Polissia, the region representing the northern half of Rivne Province (Oblast) in Ukraine. Here the patterns and population rates of malformations are reported and possible etiologic factors and regional contrasts are explored.
PATIENTS AND METHODS: Malformations, as defined by international standards, noted among all 96 438 births in Rivne between 2000 and 2006, were analyzed statistically. Contrasts of rates in Polissia compared with the rest of Rivne also were investigated.
RESULTS: The overall rate of neural tube defects in Rivne is among the highest in Europe (22.2 per 10,000 live births). The rates of conjoined twins and teratomas also seem to be elevated. In Polissia, the overall rates of neural tube defects are even higher (27.0 vs 18.3, respectively; odds ratio: 1.46 [95% confidence interval: 1.13-1.93]), and the rates of microcephaly and microphthalmia may also be elevated.
CONCLUSIONS: The malformation patterns observed suggest early disruptions of blastogenesis, manifesting as alterations of body axes, twinning, duplications, laterality, and midline formation. The results are sufficiently compelling to justify continuing and expanding this investigation of malformations in chronic low-dose radiation-impacted regions of Ukraine.