山西忻州事故中孕妇受照后第16年随访

Objective To investigate the late effect of radiation on child-bearing women,through observing "Fang",a 19-week-pregnant woman at age of 23,who was exposed to 60Co radiation in Shanxi Xinzhou radiation accident in November,1992 and diagnosed as moderate bone marrow type acute radiation sickness and recovered after 16 year of follow-up treatment.Methods Clinical data including medical history,physical examination,laboratory data,imaging findings and consulting relevant departments were reviewed.Results The followed-up woman "Fang" often felt weak and caught cold after recovery.When she was 32 years old (9 years after radiation),her hair turned grey,but without hair loss.Her menstrual quantity was lessened since 31 years old (8 years after radiation).She was remarried and pregnant twice in the same year.At the first time she underwent artificial abortion and the second child suffered from intrauterine death after 6 months of pregnancy.The physical examination found bilateral degree Ⅰ thyroid enlargement and sparse armpit hair.The laboratory test showed the increased levels of triiodothyronine,thyroxine and anti-thyroid peroxidase antibody (TMAb) and the decreased thyroid stimulating hormone (TSH).Unstable chromosome aberrations were totally lost and stable aberrations in chromosomes were detected by fluorescence in situ hybridization (FISH).The dose estimated with the residue chromosome aberration was 0.76 Gy.Other laboratory results were normal.Ultrasonic test showed diffuse lesion in bilateral thyroid and multiple cystic nodules in right lobe of thyroid,which was considered to be nodular goiter.The examination of bone mineral density (BMD) showed osteoporosis from the second to the fourth lumber vertebra.There were no diseases associated with radiation based on the consultation from related departments.Conclusions Intrauterine death after 6 months of pregnancy might be associated with the previous exposure.There is no evidence of malignant tumor,but non-cancerous diseases are obvious.

Follow-up of pregnant woman 16 years after exposure in Xinzhou radiation accident