CT findings in post-partum complications: our experience

Congress:

ECR 2020

Poster Number:

C-08338

Type:

Scientific Exhibit

Keywords:

Performed at one institution, Observational, Retrospective, Obstetrics, Acute, Complications, CT, Obstetrics (Pregnancy / birth / postnatal period), Genital / Reproductive system female, Emergency, Genitourinary

Authors:

S. Persiani¹, B. Gui², F. Perillo³, L. M. Minordi³, R. Manfredi¹; ¹Rome/IT, ²Roma (RM)/IT, ³Roma/IT

DOI:

10.26044/ecr2020/C-08338

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-08338

Table 1: CT technique

Table 2: Patient population

Table 3: Results

Fig. 1: Sagittal reformatted CT image shows a bladder flap hematoma (yellow arrow) in a...

Purpose

The post-partum period may have several acute complications (within 6-8 weeks), more frequently in the early post-delivery both vaginal and cesarean. Obstetric complications can be considered a common source both of morbidity and mortality for women of reproductive age. [1] The aim of this study is to retrospectively analyze the post-delivery urgent CTs performed in our institution in the period between 2011 and 2018 and to evaluate the most common complications detected.

Methods and materials

Ultrasonography and CT are the most used imaging techniques. US is the first choice because it can be executed at bedside, it doesn’t require ionizing radiation and it is cost-effective. However, it presents some limits, for example in demonstrating the real extent of some abnormalities. [2] That’s why we need second-level techniques: in fact, CT is usually the key to clarify doubtful US findings, to find the underlying cause of important clinical symptoms (shock, anemia), and also to rule out active arterial bleeding in case...

Results

44 of 63 patients (70%) showed significant findings: 25/44 (57%) underwent CS and 19/44 (43%) had a VD. Table 3 shows that the most frequently documented acute complication was hematoma, which was detected in 29 cases of 44 (66%), and in particular 14/29 (48%) after VD and 15/29 (52%) after CS. 6 (21%) of these 29 cases also presented active bleeding. Concerning hemorrhages after cesarean section, bladder flap hematoma is one of the most common, it was detected in more than 50% of patients presenting...

Conclusion

The most frequently documented acute complication was hematoma, with no significant differences between VD and CS and uterine dehiscence or incomplete rupture, most frequent after CS. Despite sonography continues to be the first choice, CT plays a primary role in the correct diagnosis of acute post-partum complication both vaginal and cesarean delivery in particular to clarify doubtful US findings, always in accordance with clinical data, in order to give the gynecologist precious information for a proper treatment planning.

Personal information and conflict of interest

S. Persiani; Rome (RM)/IT - nothing to disclose B. Gui; Roma (RM)/IT - nothing to disclose F. Perillo; Rome (RM)/IT - nothing to disclose L. M. Minordi; Rome (RM)/IT - nothing to disclose R. Manfredi; Rome (RM)/IT - nothing to disclose

References

Ozimek J, Kilpatrick SJ. Maternal Mortality in the Twenty-First Century. Obstet Gynecol Clin North Am. 2018 Jun; 45(2):175-186. Gui B, Danza FM, Valentini AL, et al. Multidetector CT appearance of the pelvis after cesarean delivery: normal and abnormal acute findings. Diagn Interv Radiol 2016; 22:534–541. Menias CO, Elsayes KM, Peterson CM, et al. CT of pregnancy-related complications. Emerg Radiol 2007; 13:299–306. Gui B, Corvino M, Grimaldi PP, et al. Multidetector CT appearance of the pelvis after vaginal delivery: normal appearances and abnormal acute findings. Diag...