Mistakes in Emergency Imaging of Pregnant Patients

Abstract

Radiologists play an important role in the diagnostic assessment of patients in the emergency setting. An acute abdomen in pregnancy represents one of the most challenging diagnostic and therapeutic dilemmas. The difficulty is due to the anatomical and pathophysiological changes related to pregnancy, including the different locations of abdominal and pelvic structures, displaced by the uterus, altered laboratory tests, difficult abdominal/pelvic physical examination, and non-specific symptoms. Physicians have to choose the appropriate imaging techniques in order to avoid, as much as possible, the use of ionizing radiation due to the potential risk for the fetus. Ultrasound is widely considered to be the first imaging examination that should be performed. Magnetic resonance imaging and computed tomography are used when ultrasound diagnosis is uncertain. In general, they are more accurate than ultrasound in the second and third trimesters. Magnetic resonance imaging is preferable to avoid ionizing radiation.