Acute abdominal and pelvic pain in pregnancy: ESUR recommendations

Gabriele Masselli, Lorenzo Derchi, Josephine McHugo, Andrea Rockall, Peter Vock, Michael Weston, John Spencer

Research output: Contribution to journalArticle

Abstract

Acute abdominal pain in pregnancy presents diagnostic and therapeutic challenges. Standard imaging techniques need to be adapted to reduce harm to the fetus from X-rays due to their teratogenic and carcinogenic potential. Ultrasound remains the primary imaging investigation of the pregnant abdomen. Magnetic resonance imaging (MRI) has been shown to be useful in the diagnosis of gynaecological and obstetric problems during pregnancy and in the setting of acute abdomen during pregnancy. MRI overcomes some of the limitations of ultrasound, mainly the size of the gravid uterus. MRI poses theoretical risks to the fetus and care must be taken to minimise these with the avoidance of contrast agents. This article reviews the evolving imaging and clinical literature on appropriate investigation of acute abdominal and pelvic pain during established intrauterine pregnancy, addressing its common causes. Guidelines based on the current literature and on the accumulated clinico-radiological experience of the European Society of Urogenital Radiology (ESUR) working group are proposed for imaging these suspected conditions. Key Points • Ultrasound and MRI are the preferred investigations for abdominal pain during pregnancy. • Ultrasound remains the primary imaging investigation because of availability and portability. • MRI helps differentiate causes of abdominopelvic pain when ultrasound is inconclusive. • If MRI cannot be performed, low-dose CT may be necessary. • Following severe trauma, CT cannot be delayed because of radiation concerns.

Original languageEnglish
Pages (from-to)3485-3500
Number of pages16
JournalEuropean Radiology
Volume23
Issue number12
DOIs
Publication statusPublished - Dec 2013

Fingerprint

Pelvic Pain
Acute Pain
Radiology
Abdominal Pain
Magnetic Resonance Imaging
Pregnancy
Fetus
Acute Abdomen
Abdomen
Contrast Media
Obstetrics
Uterus
X-Rays
Guidelines
Radiation
Pain
Wounds and Injuries

Keywords

  • Acute abdominal pain
  • Guidelines
  • Magnetic resonance
  • Pregnancy
  • Ultrasound

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

Masselli, G., Derchi, L., McHugo, J., Rockall, A., Vock, P., Weston, M., & Spencer, J. (2013). Acute abdominal and pelvic pain in pregnancy: ESUR recommendations. European Radiology, 23(12), 3485-3500. https://doi.org/10.1007/s00330-013-2987-7

Acute abdominal and pelvic pain in pregnancy : ESUR recommendations. / Masselli, Gabriele; Derchi, Lorenzo; McHugo, Josephine; Rockall, Andrea; Vock, Peter; Weston, Michael; Spencer, John.

In: European Radiology, Vol. 23, No. 12, 12.2013, p. 3485-3500.

Research output: Contribution to journalArticle

Masselli, G, Derchi, L, McHugo, J, Rockall, A, Vock, P, Weston, M & Spencer, J 2013, 'Acute abdominal and pelvic pain in pregnancy: ESUR recommendations', European Radiology, vol. 23, no. 12, pp. 3485-3500. https://doi.org/10.1007/s00330-013-2987-7
Masselli, Gabriele ; Derchi, Lorenzo ; McHugo, Josephine ; Rockall, Andrea ; Vock, Peter ; Weston, Michael ; Spencer, John. / Acute abdominal and pelvic pain in pregnancy : ESUR recommendations. In: European Radiology. 2013 ; Vol. 23, No. 12. pp. 3485-3500.
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