Format

Send to

Choose Destination
Emerg Radiol. 2016 Apr;23(2):105-9. doi: 10.1007/s10140-015-1367-9. Epub 2015 Nov 19.

A 10-year restrospective evaluation of ultrasound in pregnant abdominal trauma patients.

Author information

1
Department of Radiology, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103, USA. quinnmeisinger@me.com.
2
Department of Radiology, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103, USA.
3
Department of Surgery, Division of Trauma, Surgical Critical Care, and Burns, University of California, San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103, USA.

Abstract

The pregnant abdominal trauma patient presents a unique diagnostic challenge. This study aimed to evaluate the accuracy of abdominal sonography for the detection of clinically important injuries in pregnant abdominal trauma patients. A retrospective review was performed of a trauma center database from 2001 to 2011. Medical records were reviewed to determine initial abdominal imaging test results and clinical course. Sensitivity, specificity, positive predictive value, and negative predictive value of ultrasound for detection of traumatic injury were calculated. Of 19,128 patients with suspected abdominal trauma, 385 (2 %) were pregnant. Of these, 372 (97 %) received ultrasound as the initial abdominal imaging test. All 13 pregnant patients who did not receive ultrasound received abdominal CT. Seven pregnant patients underwent both ultrasound and CT. Seven ultrasound examinations were positive, leading to one therapeutic Cesarean section and one laparotomy. One ultrasound was considered false positive (no injury was seen on subsequent CT). There were 365 negative ultrasound examinations. Of these, 364 were true negative (no abdominal injury subsequently found). One ultrasound was considered false negative (a large fetal subchorionic hemorrhage seen on subsequent dedicated obstetrical ultrasound). Sensitivity and positive predictive value were 85.7 %. Specificity and negative predictive value were 99.7 %. Abdominal sonography is an effective and sufficient imaging examination in pregnant abdominal trauma patients. When performed as part of the initial assessment using an abbreviated trauma protocol with brief modifications for pregnancy, ultrasound minimizes diagnostic delay, obviates radiation risk, and provides high sensitivity for injury in the pregnant population.

KEYWORDS:

Abdomen; Pregnant; Trauma; Ultrasound

PMID:
26585759
DOI:
10.1007/s10140-015-1367-9
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center