title: Pelvic free fluid: clinical importance for reproductive age women with blunt abdominal trauma.
abstract: OBJECTIVE
  To evaluate the importance of isolated pelvic free fluid (FF) detected by ultrasound examination in pregnant patients and in non-pregnant reproductive age women with blunt abdominal trauma (BAT).
  
  
  METHODS
  Reproductive age women aged 10-50 years who presented with BAT and underwent focused abdominal sonography for trauma (FAST) from January 1995 to June 2002 at a Level 1 trauma center were included. Patients were assigned to four groups according to the location of FF detected by ultrasound (Group 1, no FF; Group 2, FF in pelvis; Group 3, FF in abdomen; Group 4, FF in abdomen and pelvis). Ultrasound findings were compared with intra-abdominal and pelvic injuries detected by computed tomography and/or laparotomy. Pair-wise comparison was performed using a Fisher's exact test.
  
  
  RESULTS
  Ultrasound detection of FF in the abdomen alone or FF in the abdomen and pelvis was significantly associated with intra-abdominal injury (IAI) compared to those without FF (P < 0.001) for both pregnant and non-pregnant reproductive age women. FF isolated to the pelvis was also associated with a higher injury rate compared to no FF in pregnant women (30% vs. 3%, P = 0.005) and in non-pregnant reproductive age women (39.5% vs. 3.7%, P < 0.001).
  
  
  CONCLUSIONS
  In reproductive age women with BAT, ultrasound detection of FF in the abdomen alone, in both the abdomen and pelvis, or isolated to the pelvis is associated with a higher IAI rate. Therefore, isolated FF in the pelvis should not necessarily be considered physiological in pregnant and non-pregnant patients with BAT.
authors.affiliation: Department of Radiology, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
authors.forename: E L
authors.initials: EL
authors.lastname: Ormsby
authors.forename: J
authors.initials: J
authors.lastname: Geng
authors.forename: J P
authors.initials: JP
authors.lastname: McGahan
authors.forename: J R
authors.initials: JR
authors.lastname: Richards
mesh_terms: D000007:Abdominal Injuries / Q000000981:diagnostic imaging*; D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D001202:Ascitic Fluid / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D006801:Humans; D008875:Middle Aged; D010388:Pelvis / Q000000981:diagnostic imaging* / Q000293:injuries; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D016216:Ultrasonography, Prenatal; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging*