Type:
Educational Exhibit
Keywords:
Performed at one institution, Not applicable, Retrospective, Obstetrics, Acute, Complications, MR, CT, Obstetrics (Pregnancy / birth / postnatal period), Emergency, Emergency Imaging
Authors:
R. J. Gravell1, H. Edwards2, J. Taylor2, D. M. Paravasthu2; 1Warrington /UK, 2Warrington/UK
DOI:
10.26044/ecr2020/C-08291
Background
Evaluating non-obstetric medical conditions during pregnancy remains diagnostically challenging. The literature suggests a suboptimal understanding amongst physicians regarding dosimetry and extent of radiation risks to this subgroup (Patel et al, 2007) despite millions of women undergoing pregnancy every year (Sedgh et al, 2012).
Ionising radiation, both a carcinogen (Shuz et al, 2017) and teratogen, pose risks to the highly radiosensitive foetus (Valentin, 2003). Good quality research into safety is difficult due to the ethical implications but dose exposure remains under constant review (Dol & Wakeford, 2014; Valentin, 2003). Notwithstanding, radiologists need the expertise and awareness to make well informed decisions to avoid the unnecessary evasion of useful diagnostic imaging (ACOG, 2017) and improve patient outcomes.
The use of MRI and ultrasound is encouraged in pregnant patients (RCR, 2009; ACOG, 2017) but often CT cannot be avoided. Identifying both common and rare non-obstetric complications in pregnancy and their desired imaging modality is imperative to assist clinical decisions and management. Algorithms exist for common clinical scenarios e.g., appendicitis, pulmonary embolism and biliary disease (Patel et al, 2007) but a greater widespread understanding amongst radiologists of non-obstetric complications should be encouraged.
We reviewed the imaging of non-obstetric acute presentations in pregnancy and postpartum states to raise awareness and improve learning around the variety of pathological entities. We hope this will improve both patient care and safety.