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Magnetic Resonance Imaging of Acute Abdominal and Pelvic Pain in Pregnancy

Furey, Elizabeth A. MD*; Bailey, April A. MD; Pedrosa, Ivan MD

Topics in Magnetic Resonance Imaging: August 2014 - Volume 23 - Issue 4 - p 225–242
doi: 10.1097/RMR.0000000000000029
Original Articles

Abstract: Evaluation of acute abdominal and pelvic pain in pregnancy presents a diagnostic challenge for clinicians and radiologists alike. The differential diagnosis includes obstetric and nonobstetric conditions unique to pregnancy, in addition to causes of acute abdominal and pelvic pain unrelated to the pregnancy. The clinical presentation and course of disease may be altered in pregnancy, and several pathologies are exacerbated by pregnancy. Discriminating clinical features in the diagnosis of abdominal and pelvic pain are often confounded by expected anatomic and physiologic changes in pregnancy. Moreover, while diagnostic pathways may be altered in pregnancy, the necessity for a timely and accurate diagnosis must be underscored, as delay in treatment may result in an undesirable increase in morbidity and/or mortality for both the patient and fetus. Advances in magnetic resonance imaging (MRI) through faster acquisition and motion-insensitive techniques, coupled with increased awareness and education regarding the value of MRI in diagnosing a wide range of pathology, have established MRI as a valuable strategy in the investigation of acute abdominal and pelvic pain in the pregnant patient. This review presents a practical approach to common obstetric and nonobstetric causes of acute abdominal and pelvic pain during pregnancy, as well as safety considerations for performing MRI in this patient population.

Supplemental digital content is available in the article.

From the Departments of *Radiology and †Obstetrics and Gynecology and ‡Advanced Imaging Research Center, University of Texas Southwestern Medical Center, Dallas, TX.

Reprints: Elizabeth A. Furey, MD, Department of Radiology, University of Texas Southwestern Medical Center (e-mail: Beth.Furey@utsouthwestern.edu).

Supplemental digital contents are available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.topicsinmri.com).

© 2014 Lippincott Williams & Wilkins, Inc.