Abdominal ultrasound examination in pregnant blunt trauma patients

Research output: Contribution to journalArticle

77 Citations (Scopus)

Abstract

Background: The ability of abdominal ultrasound to detect intraperitoneal fluid in the pregnant trauma patient has been questioned. Methods: Pregnant blunt trauma patients admitted to a Level I trauma center during an 8-year period were reviewed. Ultrasound examinations were used to detect intraperitoneal fluid and considered positive if such fluid was identified. Results: One hundred twenty-seven (61%) of 208 pregnant patients had abdominal ultrasound during initial evaluation in the emergency department. Seven patients had intra-abdominal injuries, and six had documented hemoperitoneum. Ultrasound identified intraperitoneal fluid in five of these six patients (sensitivity, 83%; 95% confidence interval, 36-100%). In the 120 patients without intra-abdominal injury, ultrasound was negative in 117 (specificity, 98%; 95% confidence interval, 93-100%). The three patients without intra-abdominal injury but with a positive ultrasound had the following: serous intraperitoneal fluid and no injuries at laparotomy (one) and uneventful clinical courses of observation (two). Conclusion: The sensitivity and specificity of abdominal ultrasonography in pregnant trauma patients is similar to that seen in nonpregnant patients. Occasional false negatives occur and a negative initial examination should not be used as conclusive evidence that intra-abdominal injury is not present. Ultrasound has the advantages of no radiation exposure.

Original languageEnglish (US)
Pages (from-to)689-694
Number of pages6
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume50
Issue number4
StatePublished - 2001

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Abdominal Injuries
Wounds and Injuries
Confidence Intervals
Hemoperitoneum
Trauma Centers
Laparotomy
Hospital Emergency Service
Ultrasonography
Observation
Sensitivity and Specificity

Keywords

  • Blunt abdominal trauma
  • Pregnancy
  • Ultrasound

ASJC Scopus subject areas

  • Surgery

Cite this

Abdominal ultrasound examination in pregnant blunt trauma patients. / Goodwin, Hillary; Holmes Jr, James F; Wisner, David H.

In: Journal of Trauma - Injury, Infection and Critical Care, Vol. 50, No. 4, 2001, p. 689-694.

Research output: Contribution to journalArticle

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abstract = "Background: The ability of abdominal ultrasound to detect intraperitoneal fluid in the pregnant trauma patient has been questioned. Methods: Pregnant blunt trauma patients admitted to a Level I trauma center during an 8-year period were reviewed. Ultrasound examinations were used to detect intraperitoneal fluid and considered positive if such fluid was identified. Results: One hundred twenty-seven (61{\%}) of 208 pregnant patients had abdominal ultrasound during initial evaluation in the emergency department. Seven patients had intra-abdominal injuries, and six had documented hemoperitoneum. Ultrasound identified intraperitoneal fluid in five of these six patients (sensitivity, 83{\%}; 95{\%} confidence interval, 36-100{\%}). In the 120 patients without intra-abdominal injury, ultrasound was negative in 117 (specificity, 98{\%}; 95{\%} confidence interval, 93-100{\%}). The three patients without intra-abdominal injury but with a positive ultrasound had the following: serous intraperitoneal fluid and no injuries at laparotomy (one) and uneventful clinical courses of observation (two). Conclusion: The sensitivity and specificity of abdominal ultrasonography in pregnant trauma patients is similar to that seen in nonpregnant patients. Occasional false negatives occur and a negative initial examination should not be used as conclusive evidence that intra-abdominal injury is not present. Ultrasound has the advantages of no radiation exposure.",
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