Abdominal Radiology

, Volume 42, Issue 4, pp 1062–1067

Trauma in pregnant women: assessing detection of post-traumatic placental abruption on contrast-enhanced CT versus ultrasound

  • Priyanka Jha
  • Giselle Melendres
  • Bijan Bijan
  • Eleanor Ormsby
  • Lisa Chu
  • Chin-Shang Li
  • John McGahan
Article

DOI: 10.1007/s00261-016-0970-x

Cite this article as:
Jha, P., Melendres, G., Bijan, B. et al. Abdom Radiol (2017) 42: 1062. doi:10.1007/s00261-016-0970-x

Abstract

Objectives

To evaluate detection of post-traumatic placental abruption with contrast-enhanced CT (CECT) and comparison with Ultrasound (US).

Methods

Picture Archive and Date System database at a level-1 trauma center was retrospectively reviewed using keywords pregnancy, trauma, and/or placental abruption over 10 years. CT was compared to US, if performed within 24 h. Two subspecialty-trained radiologists blindly reviewed the studies. Placental features on delivery and pregnancy outcomes were used as reference standard. Lack of adverse pregnancy/fetal outcome was treated as the absence of abruption.

Results

CECT was performed in 36 patients, with 27 US within 24 h. There were three complete and eight partial abruptions. Reader sensitivity for CT was 100% for both reviewers; however, specificity was 54.5% and 56.7%. No sonographic abnormality was noted in both partial and complete abruption. Using kappa statistics, inter-observer agreement was low for both CT (0.169) and US (0.078). False-positive reads were from misinterpretation of normal placental structures like cotyledons, age-related infarcts, and marginal sinus of the placenta.

Conclusions

CECT identifies post-traumatic placental abruption with high sensitivity but low specificity for clinically significant abruptions, and performs better than US. Pitfalls from normal placental structures mimicking abruption should be avoided. US markedly underdiagnoses abruption.

Keywords

Placental abruption Trauma CT Ultrasound US Computed tomography 

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Priyanka Jha
    • 1
    • 2
  • Giselle Melendres
    • 2
  • Bijan Bijan
    • 2
  • Eleanor Ormsby
    • 2
  • Lisa Chu
    • 1
    • 2
  • Chin-Shang Li
    • 3
  • John McGahan
    • 2
  1. 1.Department of Radiology & Biomedical ImagingUniversity of California San FranciscoSan FranciscoUSA
  2. 2.Department of RadiologyUniversity of California Davis Medical CenterSacramentoUSA
  3. 3.Division of Biostatistics, School of MedicineUniversity of CaliforniaDavisUSA

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