Trauma CT of 17/40 pregnancy

Case contributed by Nicola Zelow


High speed motor vehicle accident. 17 weeks pregnant.

Patient Data

Age: 25 years
Gender: Female

No free intraperitoneal fluid or gas.
Gravid uterus noted. The placenta lies anteriorly and fundally.
Previous cholecystectomy with mild prominence of the extra and intrahepatic bile ducts.
The liver, spleen, pancreas, kidneys and bowel appear unremarkable.
Fat stranding over the subcutaneous tissues of the lower abdomen and pelvis anteriorly likely relates to subcutaneous hematoma from the patient's seatbelt.
Pelvic binder noted. No pelvic fractures identified.

Case Discussion

There is a concern of potential harm to the developing fetus that causes precautionary practice to be put in place when imaging a pregnant patient.

In the context of trauma, a benefit to risk perspective is necessary to properly care for the injured pregnant patient. The degree of medical benefit needs to outweigh the risks of radiation.

While the dose of a CT scan is not insignificant, it is often well below any potentially harmful fetal absorbed dose thresholds outlined by the ACR and can be limited and optimized accordingly.1

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