• Jonathan Abraham Demma, Lisandro Luques, Lior Cohen, Uri P Dior, Gad Marom, Asaf Kedar, Naama Lev Cohain, Alon Pikarsky, Gidon Almogy, and Liat Appelbaum.
• Department of General Surgery and Traumatology, Hadassah Medical Organization and Faculty of Medicine, Hebrew University of Jerusalem, Israel.
• Isr Med Assoc J. 2023 Jun 1; 25 (6): 392397392-397.

BackgroundAbdominal pathology in pregnant patients is a frequent challenge for emergency department physicians. Ultrasound is the imaging modality of choice but is inconclusive in approximately one-third of cases. Magnetic resonance imaging (MRI) is becoming increasingly available, even in acute settings. Multiple studies have defined the sensitivity and specificity of MRI in this population.ObjectivesTo evaluate the use of MRI findings in pregnant patients presenting with acute abdominal complaints to the emergency department.MethodsThis retrospective cohort study was conducted at a single institution. Data were collected on pregnant patients who underwent an MRI for acute abdominal complaints between 2010 and 2019 at a university center. Patient demographics, diagnosis at admission, ultrasound and MRI findings, and discharge diagnosis were recorded and evaluated.ResultsIn total, 203 pregnant patients underwent an MRI for acute abdominal complaints during the study period. MRI was found without pathology in 138 cases (68%). In 65 cases (32%), the MRI showed findings that could explain the patient's clinical presentation. Patients presenting with long-standing abdominal pain (> 24 hours), fever, leukocytosis, or elevated C-reactive protein values were at a significantly increased risk of having an acute pathology. In 46 patients (22.6%), MRI findings changed the primary diagnosis and management while in 45 patients (22.1%) MRI findings improved characterization of the suspected pathology.ConclusionsMRI is helpful when clinical and sonographic findings are inconclusive, leading to changes in patient management in more than one-fifth of patients.

10 keywords...

hide…