Journal of Ultrasound (2018) 21:127–136
Uncommon obstetric and gynecologic emergencies associated
with pregnancy: ultrasound diagnosis
Ashraf Talaat Youssef
Received: 4 November 2017 / Accepted: 5 February 2018 / Published online: 3 March 2018
© Società Italiana di Ultrasonologia in Medicina e Biologia (SIUMB) 2018
Introduction Many uncommon obstetric and gynecologic problems associated with pregnancy and the early postpartum
period can lead to severe abdominal pain and be life-threatening. The patient will be in urgent need of a quick and accurate
decision. The means of management will depend on the ability to diﬀerentiate between these problems to achieve an optimal
Materials and methods 30 pregnant females attended a private obstetric ultrasound clinic with clinical picture of acute
abdomen with pregnancy. All were subjected to an ultrasound exam, the results were recorded, and the ﬁnal diagnosis was
reached based on the postoperative results.
Results Patients were classiﬁed according to their duration of pregnancy into cases with acute abdomen that occurred during
the ﬁrst trimester, during the second trimester, during the third trimester, and in the early postpartum period.
Conclusion Ultrasonography is a valuable tool for detecting the etiology and guiding the management in cases of emergency
situations faced by the obstetrician and gynecologist during pregnancy and the early postpartum period.
Keywords Obstetric/gynecological emergencies · Ultrasound · Acute abdomen · Pregnancy
Introduzione Molti rari problemi ostetrici e ginecologici associati alla gravidanza e al primo periodo post-partum possono
determinare severo dolore addominale e mettere a rischio la vita. Queste patologie richiedono decisioni rapide e accurate e
la loro gestione dipende dalla capacità di riconoscerle.
Materiali e metodi Lo studio ha incluso ha incluso 30 donne in gravidanza aﬀerenti ad una clinica ostetrica privata con
quadro clinico di addome acuto associato alla gravidanza. In tutte le pazienti è stata eseguita una ecograﬁa ostetrica e i
risultati dell’esame sono stati confrontati con quelli confrontati con i dati dell’esito postoperatorio.
Risultati Le pazienti sono state classiﬁcate in base al periodo della gravidanza, in particolare come casi di addome acuto
avvenuti durante il primo trimestre, il secondo trimestre, il terzo trimestre e nel periodo precoce del post-partum.
Conclusioni L’ecograﬁa è uno strumento prezioso nel rilevare le patologie e guidare la gestione delle pazienti con dolore
addominale severo durante la gravidanza e il periodo precoce del post-partum.
Severe abdominal pain in females during gestation can be
due to obstetric/gynecologic problems or abnormalities
related to the abdominal organs.
The obstetrician needs to diﬀerentiate among these con-
ditions. In the absence of vaginal bleeding, the diﬀerentia-
tion is hard. Most obstetricians do not have experience with
abdominal ultrasound, but many can perform an obstetric
ultrasound. Thus, they can look into the pregnancy’s and
fetus’ condition but simply cannot identify the other con-
ditions linked to the gynecologic or abdominal organs.
So, most obstetricians refer cases of acute abdomen dur-
ing pregnancy to a radiology clinic or nearby ultrasound
clinic. The patient is in urgent need of a quick and accurate
decision because the conditions may be life-threatening in
many cases. Most radiologists and specialists in the ﬁeld of
* Ashraf Talaat Youssef
Department of Radiology, Faculty of Medicine, Fayoum
University, Faiyum, Egypt