Is intravascular gadolinium based contrast material contraindicated for use in pregnant women?
Yes. Gadolinium-based contrast material is assumed to cross the blood-placental barrier and enter the fetus. Although there have been no known adverse effects to fetuses following maternal intravascular gadolinium-based contrast administration, no well-controlled studies of the teratogenic effects of gadolinium-based contrast material in pregnant women have been performed. Yet, teratogenic effects have been shown in animal studies following intravascular administration of high and repeated doses of gadolinium-based contrast material. Furthermore, gadolinium chelates may accumulate in the amniotic fluid with potential for release of free gadolinium (Gd 3+ ) ions, potentially conferring a risk for the development of NSF in the mother or fetus.
Because it is unclear how gadolinium-based contrast material will affect the fetus, gadolinium-based contrast material is contraindicated for use in pregnant women, and it is used only with extreme caution in rare cases following informed patient consent when there is a potential significant benefit to the patient or fetus that outweighs the possible but unknown risk to the fetus.