CT - Chest, Abdomen and Pelvis
Axial C+ arterial phase
Axial lung window
Axial bone window
Axial C+ portal venous phase
Coronal C+ portal venous phase
Axial bone window
Sagittal bone window
Can placental abruption be diagnosed with confidence on CT?
No. Placental abruption is not a straight forward diagnosis on CT. It can be difficult to determine whether focal placental thickening is from retroplacental clot, a normal placenta or myometrial contraction. In the third trimester, it can be particularly difficult to determine whether the appearance of the placenta is sinister or not. CT is only used to diagnose placental abruption if the CT has been performed to exclude maternal injury. If there is no concern about maternal injury then ultrasound is the investigation of choice.
Which abdominal organs are more at risk in a pregnant patient compared to a non pregnant patient?
The bladder, liver and spleen are more at risk due to elevation of the bladder out of the pelvis and displacement of the liver and spleen against the ribs.
Chest:
- Undisplaced fractures through the lateral aspects of the left 3rd-6th and the right 1st and 2nd ribs anteriorly.
Abdomen/Pelvis
- Third trimester fetus within the uterus.
- Heterogenous placental enhancement with several moderate sized non-enhancing segments, suspicious for but not diagnostic of abruption.
- Large right-sided retroperitoneal haematoma with active contrast extravasation from the right ovarian vein.
- Lap-belt subcutaneous bruising.
- Bilateral lateral wall subcutaneous contusions.