title: Acute abdominal and pelvic pain in pregnancy: ESUR recommendations.
abstract: Acute abdominal pain in pregnancy presents diagnostic and therapeutic challenges. Standard imaging techniques need to be adapted to reduce harm to the fetus from X-rays due to their teratogenic and carcinogenic potential. Ultrasound remains the primary imaging investigation of the pregnant abdomen. Magnetic resonance imaging (MRI) has been shown to be useful in the diagnosis of gynaecological and obstetric problems during pregnancy and in the setting of acute abdomen during pregnancy. MRI overcomes some of the limitations of ultrasound, mainly the size of the gravid uterus. MRI poses theoretical risks to the fetus and care must be taken to minimise these with the avoidance of contrast agents. This article reviews the evolving imaging and clinical literature on appropriate investigation of acute abdominal and pelvic pain during established intrauterine pregnancy, addressing its common causes. Guidelines based on the current literature and on the accumulated clinico-radiological experience of the European Society of Urogenital Radiology (ESUR) working group are proposed for imaging these suspected conditions.
authors.affiliation: Department of Radiology, Policlinico Umberto I. Sapienza University Rome, Rome, Italy, gabrielemasselli@libero.it.
authors.forename: Gabriele
authors.initials: G
authors.lastname: Masselli
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Derchi
authors.forename: Josephine
authors.initials: J
authors.lastname: McHugo
authors.forename: Andrea
authors.initials: A
authors.lastname: Rockall
authors.forename: Peter
authors.initials: P
authors.lastname: Vock
authors.forename: Michael
authors.initials: M
authors.lastname: Weston
authors.forename: John
authors.initials: J
authors.lastname: Spencer
mesh_terms: D000006:Abdomen, Acute / Q000175:diagnosis; D015746:Abdominal Pain / Q000175:diagnosis*; D000037:Abruptio Placentae / Q000175:diagnosis; D000291:Adnexal Diseases / Q000175:diagnosis; D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D003952:Diagnostic Imaging / Q000592:standards*; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods / Q000592:standards; D010049:Ovarian Diseases / Q000175:diagnosis; D017699:Pelvic Pain / Q000175:diagnosis*; D010922:Placenta Diseases / Q000175:diagnosis; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D018570:Risk Assessment / Q000592:standards; D014057:Tomography, X-Ray Computed / Q000592:standards; D016216:Ultrasonography, Prenatal / Q000592:standards; D014591:Uterine Diseases / Q000175:diagnosis; D014597:Uterine Rupture / Q000175:diagnosis
chemical_list: D003287:Contrast Media