The incidence of presentations of acute abdominal pain in pregnancy is approximately 1 in 500 - 635 ¹. Specific diagnoses may be confounded by the anatomical and physiological changes of pregnancy.

The objective of this educational poster is to describe the role of MRI in assessment of pregnant individuals with abdominal pain and provide imaging examples of pathologies which may be encountered

Imaging

•US first line – widely available and no radiation. However, this modality is operator dependant and inhibited by field of view and the presence of overlying structures

•MR – non ionizing and provides superior soft tissue contrast, spatial resolution and multiplanar reformats.

•CT – May be appropriate in life threatening situations such as major trauma.

MRI and gadolinium

•Gadolinium use should be avoided and brain deposition of gadolinium has been demonstrated in paediatric patients². In animal studies teratogenic effects have been observed at high doses³.

•A retrospective study which examined outcomes of patients exposed to non-contrast enhanced MRI during the first trimester (n=1720) and gadolinium enhanced MR...

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Imaging acute abdominal pain in the obstetric population can be challenging for radiologists due to the physiological changes of pregnancy. Furthermore, pregnant patients are managed in obstetrics hospitals, however the work-up for potential non obstetric causes of abdominal pain often necessitate transfer to a hospital with the availability of acute medical and surgical services. The general radiologist may not have extensive experience interpreting these images and it is important to be familiar with their appearance. MRI is a valuable adjunct to ultrasonography, especially in cases where the diagnosis is unclear, demonstrating diagnostic accuracy for many causes of abdominal pain in the pregnant patient.

References

1.Augustin G, Majerovic M. Non-obstetrical acute abdomen during pregnancy. Vol. 131, European Journal of Obstetrics and...

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