Normal 23/40 pregnancy on trauma CT

Case contributed by Frank Gaillard
Diagnosis certain

Presentation

MVA. Trapped in car for 1 hour. Lower limb fractures.

Patient Data

Age: 40 years
Gender: Female

Uterus in keeping with the given gestational stage. The placenta is anterior. 

No free intraperitoneal fluid or gas. Retroperitoneal and mesenteric vessels normal. Minor gallbladder wall thickening which is of doubtful significance in this context. The liver, pancreas, spleen, kidneys are intact.

Incidentally noted two segment VIII cysts, this one measuring 3 mm, the other measuring 8 mm. Incidentally noted 8mm left adrenal nodule likely to represent an adenoma. The right adrenal gland is normal

Case Discussion

In the setting of significant trauma, even though direct irradiation of the fetus is undesirable, ensuring that the mother (and thus the fetus too) do not have life threatening injuries is critical and management should be similar to non-pregnant patients. The dose, although not insignificant, still carries only a tiny risk. 

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