NEW PLACEMENT OF TIPS DURING PREGNANCY FOR RECURRING ESOPHAGEAL VARICEAL BLEEDING - ESTIMATION OF FETAL RADIATION EXPOSURE

Recurrent variceal bleeding due to liver cirrhosis led to treatment wi th a transjugular intrahepatic portosystemic shunt (TIPS) in a pregnan t woman at 20 weeks' gestation. Fetal radiation exposure was estimated to be less than 10 mSv. The use of a graduated catheter allowed measu rement of field size and reliable determination of the patient's entra nce dose. Radiation exposure of an approximated fetal dosage of 5.2 mS v did not justify abortion for medical reasons. Therefore, TIPS proced ure is not generally contraindicated during pregnancy itself. TIPS pla cement may be a therapeutic option related to the severity of the unde rlying maternal disease, after radiation exposure of the fetus has bee n estimated.