Ana P. Lourenco MD, Presenter: Nothing to Disclose

1) Recognize the sonographic appearance of common and uncommon obstetric emergencies. 2) Demonstrate understanding of management for emergent obstetric diagnoses. 3) Identify those cases requiring additional imaging, beyond US, for definitive diagnosis.

In this refresher course focused on US of Obstetrical Emergencies, we will review the key imaging findings and management of both common and uncommon obstetrical emergencies. As many hospitals and radiology practices may not routinely evaluate pregnant patients, these are particularly important topics to review. Timely and accurate diagnosis is critical to improved outcomes for both the mother and fetus. The range of topics to be reviewed will cover the first, second, and third trimester, as well as the immediate post-partum period. Diagnoses will include ectopic pregnancy, with a focus on the less commonly encountered types of ectopics – cervical, C-section scar, interstitial, and ovarian ectopics. We will also review the imaging findings of ovarian hyperstimulation as well as associated complications, which can be potentially life-threatening. Ovarian torsion in pregnancy will be discussed, as the hormonal changes of pregnancy and mass effect from corpus luteal cysts of pregnancy or other masses may predispose patients to torsion. Furthermore, the non-specific clinical presentation often makes the diagnosis challenging. Similarly, the presentation of acute appendicitis in pregnancy may be non-specific. Imaging findings of acute appendicitis in pregnancy will be reviewed, as accurate diagnosis prior to appendiceal rupture can markedly improve outcomes for both mother and fetus. Placental abnormalities will be reviewed, including placenta previa, placental abruption, and abnormal placentation (accreta, increta, percreta). Imaging findings of cervical incompetence will be reviewed, as well as important next steps in clinical management once this diagnosis is discovered. We will also review the sonographic findings of uterine dehiscence, which although rare, is potentially catastrophic to both mother and fetus. Lastly, we will review the imaging findings of retained products of conception, most commonly presenting in the immediate post-partum period.

http://media.rsna.org/media/abstract/2014/14002058/RC508A sec.pdf

Lourenco, A, US of Obstetrical Emergencies.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14002058.html