How should facilities accommodate a declared pregnant worker to minimize fetal exposure during medical imaging?

• A. Continue as planned; no shielding; ignore fetal dose.
• B. Reassign to tasks with lower exposure; implement ALARA; monitor fetal dose; shielding; limit time; document.
• C. Remove pregnancy.
• D. Increase exposure.

Answer: (B)

Protecting the fetus from ionizing radiation is the priority, so the best approach is to apply ALARA and adjust the worker’s duties to minimize exposure. Reassigning to tasks with lower exposure reduces the amount of scattered radiation reaching the abdomen and uterus, which is the most effective way to keep fetal dose small. Implementing ALARA means optimizing imaging practices so you achieve the needed diagnostic result with the least radiation possible—this can include using the lowest acceptable dose settings, employing pulsed fluoroscopy, and choosing imaging techniques that produce adequate image quality with less exposure.

Shielding helps further reduce dose to the fetus by blocking scattered radiation when the abdomen is covered with a properly fitted lead shielding. Limiting the time spent near exposure sources also lowers cumulative dose, and increasing distance from the source takes advantage of the inverse-square law to reduce exposure.

Monitoring fetal dose provides a way to verify that the fetus stays well below regulatory limits and to guide any necessary adjustments. Documentation ensures there is a formal record of the pregnancy, the protective measures implemented, and the fetal dose results, supporting compliance and communication across the team.

Choosing to continue without shielding and ignore fetal dose, removing the pregnancy, or increasing exposure would not protect the fetus and would violate protection principles.