Imaging of pelvic postpartum complications.

Zuckerman, James E.; Levine, Deborah; Mcnicholas, M. M. J.; Konopka, Sarah N.; Goldstein, Alan S.; Rr, Edelman; McArdle, Colin R.

doi:10.2214/ajr.168.3.9057511

Cited by 71 publications

(28 citation statements)

References 2 publications

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“…Fluid and echogenic debris consistent with hemorrhage or clot are common findings. Echogenic foci with distal shadowing or ring-down artifacts may be seen in patients with air in the endometrial cavity, which presents a concern for infection ( fig 1c) [1,27]. Making a clinical correlation (enlarged tender uterus) with the presence of fever and purulent vaginal discharge is important [10].…”

Section: Endometritismentioning

confidence: 99%

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Ultrasonographic evaluation of acute pelvic pain in pregnant and postpartum period

2017

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Acute pelvic pain in pregnant and postpartum patients presents diagnostic and therapeutic challenges. The interpretation of imaging findings in these patients is influenced by the knowledge of the physiological changes that occur during the pregnant and postpartum period, as well as by the clinical history. Ultrasonography remains the primary imaging investigation of the pregnant and postpartum women. This article describes the causes and imaging features of acute pelvic pain in pregnant and postpartum period and suggests characteristics to such diseases, focusing on the ultrasonography features that allow one to arrive at the corrective diagnosis. Knowledge of the clinical settings and imaging features of acute pelvic pain in pregnant and postpartum period can lead to accurate diagnosis and appropriate management of the condition.

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Section: Endometritismentioning

confidence: 99%

“…On US, RPOCs have a variable appearance, ranging from an abnormal endometrial-myometrial interface to the presence of heterogeneous echogenic crescentic material [2,27]. Focal areas of hyperechogenecity may represent retained placental calcifications [2].…”

Section: Retained Products Of Conception (Rpoc)mentioning

confidence: 99%

Ultrasonographic evaluation of acute pelvic pain in pregnant and postpartum period

2017

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“…41,42 CT scans are particularly beneficial in the diagnosis of ovarian vein thrombosis and has been cited in a few papers as being the modality of choice. 43,44 CT findings are conclusive when a dilated pelvic vein is seen with enhancing walls containing a central low-attenuation (thrombus). The right ovarian vein is involved in 80 to 90% of cases, with 10% of cases being bilateral 45 Multiplanar reconstruction may be crucial in the aid of distinguishing a dilated ureter or an inflamed appendix from a dilated ovarian vein with a thrombus.…”

Section: Ovarian Vein Thrombosis (Ovt)mentioning

confidence: 99%

Imaging Modalities in Gynecology

Busse¹

2010

Donald School Journal of Ultrasound in Obstetrics and Gynecology

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REVIEW ARTICLE DSJUOG ULTRASOUNDTransabdominal gynecologic ultrasound combined with transvaginal scanning is a technique that was initially introduced in the early 1980's and quickly became a "musthave" procedure for gynecologists and emergency room physicians for assistance in diagnosing many gynecologic conditions. Rapid advances in the quality of the equipment, techniques used to obtain best images, and research designed to help physicians interpret their findings have contributed to ultrasound's quick rise in use and popularity. It is ubiquitous that ultrasound is the imaging modality of choice for gynecologic conditions.The advantages of ultrasound are numerous. It is fast, easy to obtain, has a high patient tolerance and is relatively inexpensive when compared to CT and MRI. Many physicians' offices have ultrasound machines that are more than sufficient to make common diagnoses thereby alleviating patient anxiety and physician concerns if an abnormality is found during a physical exam. Appropriate referrals and treatments can be initiated in a timely manner at minimum expense. The ability to use the transvaginal ultrasound as an extension of a pelvic exam is extremely useful, particularly when the source of pain is uncertain during bimanual exam or if a mass is found of uterine or ovarian origin. An obvious advantage, especially when compared to CT, is that no radiation exposure occurs. As will be discussed in more detail, pelvic ultrasound has been shown, in numerous studies, to have a high negative predictive value and offers excellent resolution of the uterus and adnexal structures, especially when compared to CT and MRI.There are disadvantages; however, that should be addressed. Even with routine use of transabdominal scanning which utilizes the acoustic window of a full bladder, the field of view is very limited, especially, compared to CT and MRI. Transvaginal sonography limits the field; however, it is effective in obtaining excellent resolution of the uterus, endometrium and adnexal structures. Ultrasound visualizes the bowel poorly and it is well-known that bowel gas corrupts the ultrasound signal allowing for potential "missed" masses not visible under the bowel. An additional drawback is that poor contrast occurs between dissimilar tissues (i.e. blood and fat) making it difficult to characterize certain ovarian masses accurately.Ultrasound characterizes gynecologic pathology extremely well. Fibroids, endometriomas, dermoids, masses that are suspicious for malignancy, uterine anomalies, IUD complications, ectopic pregnancies, and endometrial pathology (with the help of transvaginal saline infusion sonography) are diagnoses that are detected with high accuracy. The following will give illustrations of the clinical utility of diagnostic gynecologic ultrasound for specific clinical conditions. AbstractAlthough ultrasound is the primary imaging modality for most gynecologic diagnoses and conditions, knowledge of other diagnostic imaging procedures is important to gynecologists, emergency room physici...

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“…59 Trans-abdominal and transvaginal ultrasound should be performed together as transabdominal sonography visualises the abdomen and pelvis for haematoma or pelvic collections. Transvaginal ultrasound facilitates high resolution examination of the uterus and adnexae and importantly facilitates detailed examination of the endometrial cavity.…”

Section: Imaging In the Post-partum Periodmentioning

confidence: 99%

“…The distinction between these two common clinical entities is important as patients with RPOC typically require dilatation and curettage, a procedure which should be avoided in patients with endometritis due to increased incidence of associated complications. 59 CT and MR imaging are usually not required in the postpartum period and are reserved for complications such as ovarian vein thrombosis, fluid collection, haematoma or abscess in the post-partum period 59 (Figure 6). …”

Section: Imaging In the Post-partum Periodmentioning

confidence: 99%