Efficacy of magnetic resonance imaging among pregnant patients diagnosed with acute abdomen in the emergency department

Abstract

Aims: Diagnostic procedures are very important for fetal safety during pregnancy. Magnetic resonance imaging (MRI) is characterized by a higher accuracy rate compared to medical follow-up and post-surgical diagnoses. However, it is very important to use it at the right time in order to maintain cost-effectiveness of the technique. In this study, we aimed to determine the efficacy of MRI in pregnant patients admitted to the emergency department with acute abdominal pain when the etiology has not been defined by other techniques. Methods: The data of pregnant patients who admitted to the emergency department due to acute abdominal pain between January 2013 and February 2018 were retrospectively analyzed. All these patients evaluated with pelvic magnetic resonance screening, as they could not be diagnosed by physical examination findings, laboratory tests, or ultrasonography. Diagnostic performance of MRI, sensitivity, specificity, and negative and positive predictive values were assessed. Results: The etiology of the pain was detected in 29 of 57 patients who applied to the emergency department with acute abdominal pain and evaluated with pelvic MRI. The most common cause of acute abdominal pain was acute appendicitis which all of them histopathologically confirmed (n=14). Pelvic abscess, severe hydronephrosis, giant ovarian cyst, pyelonephritis, ovarian torsion, and uterine fibroid torsion were among other causes. Conclusion: MRI is a highly effective imaging method for diagnosing both acute appendicitis and other pelvic emergencies. Therefore, it would be beneficial for the diagnosis in pregnant patients with acute abdominal pain.