Diagnostic imaging in postpartum complications: a pictorıal review

Congress:

ECR 2024

Poster Number:

C-23335

Type:

Educational Exhibit

Keywords:

Abdomen, Emergency, Genital / Reproductive system female, CT, MR, Ultrasound-Colour Doppler, Complications, Diagnostic procedure, Normal variants, Arteriovenous malformations, Haemorrhage, Obstetrics

Authors:

V. Çakmak, D. HEREK, A. Y. Yitik, P. Çakmak, G. Güngör

DOI:

10.26044/ecr2024/C-23335

DOI-Link:

https://dx.doi.org/10.26044/ecr2024/C-23335

Learning objectives

The aim of this article is to discuss the imaging findings in postpartum gynecological/obstetric complications.

Background

Puerperium & Imaging TechniquesThe puerperium (postpartum period) begins after the uterine termination of the fetus and placenta, This period lasts 6-8 weeks and is the time when the physiological changes due to pregnancy return . The pregnancy-related mortality rate is reported to be 17 to 28 per 100,000 live births in the United States, and the cesarean (C/S) delivery rate is 26.1% t o 30.2% [1]. The increase in the rate of cesarean delivery increases the frequency of postpartum complications. Although postpartum hemorrhages are divided...

Findings and procedure details

SURGICAL COMPLICATIONS1-Retained products of conception/ Rest placentaPlacental material originating from the residual trophoblast after birth or termination of pregnancy is defined as placental retantion material [7]. Clinically, it is abdominal/pelvic pain and vaginal bleeding. Abortion is more common in surgical termination and gestational trophoblastic disease than in normal or C/S births [8]. Ultrasonography and Doppler are the first imaging methods used in diagnosis. On ultrasound, the placental retention material is seen as an echogenic mass in the endometrial cavity and a called-out endometrium. In this...

Conclusion

The findings of normal uterine changes in the puerperium and some postpartum complications overlap with each other. Knowledge of the pathophysiology and diagnostic imaging findings of complications that may develop in addition to physiological changes in the postpartum period is important for appropriate and timely treatment.

Personal information and conflict of interest

V. Çakmak: Nothing to disclose D. HEREK: Nothing to disclose A. Y. Yitik: Nothing to disclose P. Çakmak: Nothing to disclose G. Güngör: Nothing to disclose

References

Plunk M, Lee JH, Kani K, Dighe M. Imaging of postpartum complications: a multimodality review. AJR Am J Roentgenol. 2013;200:143-154. https://doi.org/10.2214/AJR.12.9637 Laifer-Narin SL, Kwak E, Kim H, Hecht EM, Newhouse JH. Multimodality imaging of the postpartum or posttermination uterus: evaluation using ultrasound, computed tomography, and magnetic resonance imaging. Curr Probl Diagn Radiol. 2014;43:374-385. https://doi.org/1067/j.cpradiol.2014.06.001 Gonzalo-Carballes M, Ríos-Vives MÁ, Fierro EC, et al. A Pictorial Review of Postpartum Complications. Radiographics. 2020;40:2117-2141. https://doi.org/10.1148/rg.2020200031 Kostrubiak DK, DeHay PW, Akselrod DG, D'Agostino R, Tam JK. Emergent postpartum pelvic sonography....

Fig 1: An increase in uterine size and millimetic air densities(yellow arrow) in the...

Fig 2: A) Fat-suppressed axial T1A, B) axial T2A, and C) postcontrast axial T1A images...

Fig 3: The 34-year-old patient, who had irregular follow-up during pregnancy, had...

Fig 4: T1 A MRI image with axial contrast of a 22-year-old female patient, absenteeism...

Fig 5: Bladder flap hematoma: In the postpartum MRI images of a 33-year-old female...

Fig 6: Rectus Hematoma: A 36-year-old female patient was diagnosed as rectus hematoma...

Fig 7: Contrast-enhanced A) axial and B) sagittal CT images of a 28-year-old...

Fig 8: A) Axial CT scan of a 38-year-old female patient reveals a lobule-contoured...

Fig 9: In the axial contrast-enhanced CT images of the postpartum patient who...

Fig 10: In the axial contrast-enhanced CT image of a 29-year-old postpartum patient...