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Sonographic Imaging of Maternal Complications of Pregnancy

Department of Radiology, Harvard Medical School, Brigham and Women’s Hospital, Boston, Massachusetts USA.

Address correspondence and reprint requests to Donald Di Salvo, MD, Department of Radiology, Brigham and Women’s Hospital, 75 Francis St, Boston, MA 02115 USA.

Objective. To show the role of diagnostic sonography in delineating pathologic conditions occurring during and immediately after pregnancy. Methods. Cases illustrative of a broad range of pathologic conditions were collected primarily from personal experience in a busy ultrasound clinic serving high- and low-risk pregnancies over the past 15 years, with supplemental cases drawn from departmental teaching files. Sonography was the primary diagnostic tool, with confirmation obtained from other imaging modalities in select instances. Results. Cases were organized on an anatomic and time-of-onset basis. For conditions occurring during pregnancy, the following anatomic areas are considered: the liver and biliary tree, urinary tract, bowel, ovary, and uterus and placenta. For postpartum complications, the following conditions are discussed: subfascial and bladder flap hematomas, retained products of conception, and ovarian vein thrombophlebitis. Although the main imaging modality in these conditions was sonography, correlation with computed tomography and magnetic resonance imaging was also made in several cases. Conclusions. A broad variety of conditions can affect the pregnant patient, both during and immediately after pregnancy. Sonography can show many of these disease processes, with computed tomography and magnetic resonance imaging useful selectively as supplementary tools.

Key Words: complications of pregnancy • maternal • ultrasound

Abbreviations: CT, computed tomography • HELLP, hemolysis, elevated liver enzymes, and low platelets • IVC, inferior vena cava • MRI, magnetic resonance imaging • RI, resistive index

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