title: Sonographic evaluation for intra-abdominal hemorrhage after cesarean delivery.
abstract: OBJECTIVE
  To evaluate whether intra-abdominal hemorrhage is visible on a modified focused assessment with sonography for trauma (FAST) examination in stable obstetrics patients after a nonemergent cesarean delivery.
  
  
  METHODS
  This was a prospective observational study of patients who underwent nonemergent cesarean delivery at a single institution. Patients provided written informed consent to participate in the study preoperatively and underwent a modified FAST examination in the recovery room within 2 hours of completion of surgery. A sonographic examination was considered positive for hemorrhage if an anechoic pocket consistent with free fluid was present.
  
  
  RESULTS
  One hundred patients underwent suprapubic and bilateral upper-quadrant sonographic evaluations. The mean (±SD) time of the evaluation was 74.2 ± 36 minutes after the end of surgery. Among the 100 sonographic examinations of each upper quadrant, 194 (97.0%) were negative, 5 (2.5%) were indeterminate, and 1 (0.5%) was positive for fluid. All suprapubic sonographic examinations were considered inadequate.
  
  
  CONCLUSIONS
  Sonographic evaluation immediately after cesarean delivery is feasible in most patients and was overwhelmingly negative for intra-abdominal hemorrhage in a group of patients who did not require reoperation or unexpected blood transfusion.
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611.
authors: Claire
authors: C
authors: Hoppenot
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611.
authors: Joan
authors: J
authors: Tankou
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611.
authors: Sabrina
authors: S
authors: Stair
authors: Department of Obstetrics and Gynecology, Feinberg School of Medicine, Northwestern University, Chicago, IL, 60611.
authors: Dana R
authors: DR
authors: Gossett
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000009:adverse effects*; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006465:Hemoperitoneum / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D019106:Postoperative Hemorrhage / Q000175:diagnosis* / Q000209:etiology; D011247:Pregnancy; D011446:Prospective Studies; D014463:Ultrasonography / Q000379:methods*
keywords: FAST scan; cesarean delivery; obstetrics; postpartum hemorrhage; ultrasonography for intra-abdominal fluid