Emergency Imaging of the Pregnant Patient: General Principles

Emergent and traumatic scenarios are experienced by a non-trivial portion of the pregnant population. Complex physiologic changes in pregnancy, from expected elevated normal ranges in blood work, to the gravid uterus confounding physical examination findings, complicate accurate diagnosis. Physiologic changes experienced by the pregnant patient places her at increased risk for potential complications. Imaging examinations are crucial for the assessment and management of emergent medical conditions in pregnancy. Due to the potential risk of radiation exposure on the fetus, typical imaging techniques such as computed tomography are limited in their use for only select clinical scenarios, and require special consideration to minimize effects on the fetus. Due to the lack of ionizing radiation, ultrasound and magnetic resonance imaging play a vital role in the work up of the pregnant patient in the emergency department. By understanding the complex physiologic changes experienced by the pregnant patient in common emergency scenarios, as well as imaging considerations for the fetus, we aim to clarify the utilization of imaging examinations in the emergency evaluation of the pregnant patient.