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Gui B, Corvino M, Grimaldi PP, Russo L, Di Marco M, Valentini AL, Carducci B, Lanzone A, Manfredi R. Multidetector CT appearance of the pelvis after vaginal delivery: normal appearances and abnormal acute findings. Diagn Interv Radiol 2019; 25:210-218. [PMID: 31063140 PMCID: PMC6521907 DOI: 10.5152/dir.2019.18127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2018] [Revised: 04/30/2018] [Accepted: 10/12/2018] [Indexed: 12/12/2022]
Abstract
Vaginal delivery is the most commonly performed delivery in the world and accounts for nearly two-thirds of all deliveries in the United States. It is a secure method but may be associated with some acute complications, especially in the immediate postpartum days, which can potentially be fatal for the mother. The most frequent acute complications are hemorrhages/hematomas, uterine rupture, endometritis, retained product of conception (RPOC), ovarian thrombosis and HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count). A first evaluation of the clinical status of the patients is executed by the clinicians who, depending on their experience, perform ultrasonography by themselves and eventually may request further radiologic exams in doubtful cases. Radiologists may play an important role recognizing early postpartum complications and differentiating them from physiologic postoperative findings. In this setting, the use of multidetector computed tomography (MDCT) is important for diagnosis of suspected postpartum complications. The aim of this article is to review the normal and abnormal post vaginal delivery MDCT aspects in order to help the clinical management by preventing misdiagnoses and tailoring the best medical treatments.
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Affiliation(s)
- Benedetta Gui
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Miriam Corvino
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Pier Paolo Grimaldi
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Luca Russo
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Margò Di Marco
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Anna Lia Valentini
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Brigida Carducci
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Antonio Lanzone
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
| | - Riccardo Manfredi
- From the Departments of Radiological Sciences (B.G. , M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.) and Obstetrics and Gynecology (B.C., A.L.), Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences (M.C., P.P.G., L.R., M.D.M., A.L.V., R.M.), Università Cattolica del Sacro Cuore, Roma, Italy; Department of Obstetrics and Gynecology (A.L.), Università Cattolica del Sacro Cuore, Roma, Italy
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