• E L Ormsby, J Geng, J P McGahan, and J R Richards.
• Department of Radiology, University of California, Davis Medical Center, Sacramento, CA 95817, USA.
• Ultrasound Obstet Gynecol. 2005 Sep 1;26(3):271-8.

ObjectiveTo 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).MethodsReproductive 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.ResultsUltrasound 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).ConclusionsIn 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.

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