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ARKA Clinical Decision Support is designed to meet all four criteria for Non-Device CDS under FD&C Act §520(o)(1)(E) and FDA's January 2026 final guidance on Clinical Decision Support Software. Recommendations support, not replace, the clinician's judgment. Every recommendation is anchored in a published guideline or peer-reviewed source, with the basis available for independent review. CLIN emphasizes imaging appropriateness at order entry.

This recommendation is intended to support, not replace, clinical judgment. It is generated by ARKA, software designed to meet the four criteria for Non-Device Clinical Decision Support under FD&C Act §520(o)(1)(E) and FDA's final guidance on Clinical Decision Support Software (January 2026). The clinician is responsible for the final decision.

Regulatory rationale Feature catalog Trust center

Evidence library

AIIE Evidence

Imaging in pregnancy — modality selection and fetal safety

Cross-Cutting Principles

Last reviewed 2026-06-01

Knowledge Matrix v1.0.0

Clinical bottom line

Prefer US and non-contrast MRI in pregnancy; perform a clearly indicated CT when alternatives are inadequate — diagnostic delay harms both patients.

Summary

Ultrasound and MRI (without gadolinium) are the preferred modalities throughout pregnancy. Diagnostic X-ray and CT doses are generally below fetal harm thresholds, and a medically indicated study should never be withheld solely because of pregnancy — but a radiation-free alternative is preferred when diagnostically adequate.

Key points

ACOG: ultrasound and MRI are not associated with fetal risk when used appropriately.
Gadolinium is avoided in pregnancy; iodinated contrast may be used when essential.
Single diagnostic CT doses fall below deterministic fetal-effect thresholds.