Get a Group Membership for your Organization. Free Trial
Pricing
Free TrialLogin

Introduction: Abdominopelvic Pathology During Pregnancy

HIDE
PrevNext

0:00

A common indication for imaging

0:02

in the context of pregnancy is

0:04

suspected abdominal pelvic pathology.

0:07

There are numerous potential causes of

0:09

abdominal pain in the pregnant patient,

0:11

both obstetric and non-obstetric.

0:15

Ultrasound remains the first-line imaging

0:17

modality, whether you think the cause

0:20

is obstetric or something more focal,

0:23

such as right upper quadrant pain with

0:25

suspicion for acute biliary pathology.

0:29

CT is indicated in the pregnant patient

0:31

in high-acuity situations, including

0:34

trauma and suspected pulmonary embolism.

0:37

An MRI can be useful for troubleshooting

0:40

or further characterizing findings

0:42

that are detected at initial imaging.

0:45

This is a list of many, but not all, of

0:47

the potential causes of abdominopelvic

0:50

pain and pathology during pregnancy.

0:54

These include gastrointestinal etiologies,

0:57

very commonly acute appendicitis,

0:59

cholecystitis, or pathology involving the

1:02

gallbladder and biliary tree, HELLP syndrome,

1:05

which is hemolysis with elevated liver

1:07

enzymes and low platelets, which does occur

1:10

in pregnant patients, pancreatitis, bowel

1:13

obstruction, and inflammatory bowel disease.

1:17

Genitourinary causes of abdominopelvic

1:19

pain are also fairly common in pregnancy,

1:22

including hydronephrosis of pregnancy,

1:24

which is technically not pathologic, but is

1:27

something you'll see because of mass effect

1:29

of the gravid uterus on the distal ureter.

1:32

Pregnant patients can also get

1:33

obstructing stones or pyelonephritis.

1:37

There are multiple gynecologic causes of

1:39

abdominopelvic pain, including those

1:41

related to the ovaries, such as ovarian

1:43

torsion, ovarian cysts, adnexal masses,

1:46

as well as uterine causes, such as

1:48

fibroids, endometriosis, or mixed

1:51

etiologies, such as tubo-ovarian abscess

1:54

and pelvic inflammatory disease.

1:57

Obstetrical causes of abdominal

1:58

pelvic pain include ectopic pregnancy,

2:01

placentation abnormalities, including

2:03

placenta accreta spectrum, placental

2:05

abruption, and preterm labor.

2:09

Vascular etiologies include pelvic

2:11

congestion syndrome, something that we

2:13

see not infrequently, particularly later

2:15

in pregnancy, and deep venous thrombosis,

2:18

as pregnancy is a hypercoagulable state.

2:21

Finally, it's important to remember that

2:24

pregnant patients are just as susceptible to

2:26

trauma as the general population, but are at

2:28

a higher risk of intimate partner violence.

Report

Faculty

Erin Gomez, MD

Assistant Professor of Radiology

Johns Hopkins Hospital

Tags

Women's Health

Ultrasound

MRI

Gynecologic (GYN)

Genitourinary (GU)

CT

Body

© 2024 MRI Online. All Rights Reserved.

Contact UsTerms of UsePrivacy Policy