Medical care and pregnancy - Diagnostic testing

Diagnostic measures that would normally be employed
to evaluate the acute complaint can almost
always be used in pregnancy. Ultrasound modalities
(abdominal, renal, breast, and vascular) are considered
safe, although there may be some decrease in
accuracy of venous studies caused by the enlarged
uterus and inferior vena cava compression. If a renal
ultrasound is insufficient for evaluation of suspected
nephrolithiasis, a stone-protocol CT or single-shot
intravenous pyelogram may be utilized to assist in
management.
Diagnostic peritoneal lavage and/or computed
tomography (CT) scan of the abdomen may be indicated
in the evaluation of trauma; this modality
should not be neglected if clinically indicated, since
the single greatest cause of mortality for pregnant
women is motor vehicle accidents.
Physicians should not hesitate to utilize chest
X-rays when evaluating patients with symptoms suggestive
of serious acute illness, such as pneumonia.24
Flexible sigmoidscopy has been studied in all trimesters,
with efficacious diagnosis of gastrointestinal
bleeding and without negative outcomes.25
Nuclear medicine studies should be avoided. Multiple surgical series at this time support the
safety and utility of laparoscopic surgery during pregnancy.
Although timing of surgical procedures in
pregnancy is best during the second trimester to
decrease the risk of abortion and premature labor,
surgical treatment of trauma, appendicitis, and biliary
tract disease may not be able to be delayed.
The best time to perform surgical procedures in pregnancy
is during the second trimester to decrease the
risk of abortion and premature labor.

Posted in: Health,Medical care and pregnancy