Department of Radiological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy.
Department of Radiological Sciences, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Roma, Italy; Department of Radiological Sciences, Università Cattolica del Sacro Cuore, Roma, Italy.
Diagn Interv Radiol. 2019 May;25(3):210-218. doi: 10.5152/dir.2019.18127.
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.
阴道分娩是世界上最常见的分娩方式,占美国所有分娩的近三分之二。它是一种安全的方法,但可能与一些急性并发症有关,特别是在产后即刻,这可能对母亲致命。最常见的急性并发症是出血/血肿、子宫破裂、子宫内膜炎、妊娠产物残留(RPOC)、卵巢血栓形成和 HELLP 综合征(溶血、肝酶升高、血小板计数低)。临床医生首先对患者的临床状况进行评估,根据他们的经验,自行进行超声检查,并在可疑情况下最终可能要求进行进一步的放射学检查。放射科医生在识别早期产后并发症并将其与生理性术后发现区分开来方面可能发挥重要作用。在这种情况下,使用多排 CT(MDCT)对诊断疑似产后并发症很重要。本文旨在回顾阴道分娩后 MDCT 的正常和异常表现,以通过防止误诊和制定最佳的医疗治疗来帮助临床管理。