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Safe and pivotal approaches using contrast-enhanced ultrasound for the diagnostic workup of non-obstetric conditions during pregnancy, a single-center experience

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Conventional ultrasound is the main imaging modality in obstetrics for assessing the maternal and fetal status. Up to date, contrast-enhanced ultrasound (CEUS) has not found widespread use in gynecology and obstetrics, but recent studies demonstrate promising results. The aim of the present study is to assess safe and valuable application of CEUS during pregnancy to investigate non-obstetric conditions.

Methods

Five pregnant patients on whom CEUS was performed between 2019 and 2020 were included in this retrospective single-center study. A total of six CEUS examinations were performed including one CEUS-guided biopsy (mean age: 31 years, mean weeks of pregnancy: 18 weeks). CEUS examinations were performed by a consultant radiologist (EFSUMB level 3).

Results

All included pregnant women safely underwent CEUS. Neither maternal nor fetal adverse effects were detected. CEUS critically helped in the diagnostic workup of a desmoid tumor of the abdominal wall, hepatic hemangioma, amebic hepatic abscess, uncomplicated renal cyst and post-inflammatory alteration of the renal cortex and for excluding active abdominal bleeding. In addition, CEUS-guided biopsy was performed to prevent intratumoral hemorrhage. Findings from CEUS prompted immediate treatment in two women, whereas in three women regular obstetric monitoring of the women could be conducted.

Conclusion

Our results demonstrate safe and crucial application of off-label CEUS in pregnant women to assess different non-obstetric conditions allowing to prevent additional ionizing CT or application of (gadolinium-based) contrast agent in MRI. Hence, CEUS might add pivotal value for evaluating obstetric and non-obstetric conditions and thereby directing clinical management of pregnant women in the future.

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Abbreviations

CEUS:

Contrast-enhanced ultrasound

CT:

Computed tomography

GBCA(s):

Gadolinium-based contrast agent(s)

MRI:

Magnetic resonance imaging

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Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Radiology, University Hospital LMU, Ludwig-Maximilians-University Munich, Grosshadern Campus, Munich, Germany

    Vincent Schwarze, Constantin Marschner, Johannes Rübenthaler & Dirk-André Clevert

  2. Institute of Clinical Radiology and Nuclear Medicine, University Medical Center Mannheim, Mannheim, Germany

    Matthias Frank Froelich

  3. Institute of Pathology, University Hospital LMU, Ludwig-Maximilians-University Munich, Grosshadern Campus, Munich, Germany

    Thomas Knösel

Authors
  1. Vincent Schwarze
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  2. Matthias Frank Froelich
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  3. Constantin Marschner
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  5. Johannes Rübenthaler
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  6. Dirk-André Clevert
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Contributions

VS: project development, data collection, data analysis, manuscript writing/editing, final approval of the manuscript. MFF: data analysis, manuscript editing, final approval of the manuscript. CM: data analysis, manuscript editing, final approval of the manuscript. TK: data analysis (histopathologic analysis), manuscript editing, final approval of the manuscript. JR: project development, data analysis, manuscript editing, final approval of the manuscript. DAC: project development, data collection (every CEUS examination), manuscript editing, final approval of the manuscript.

Corresponding author

Correspondence to Vincent Schwarze.

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Conflict of interest

There is no conflict of interest to disclose by the authors.

Ethics approval

This retrospective single-center study was approved by the local institutional ethical committee of the institutional review board (Ethics Committee, Medical Faculty, Ludwig-Maximilians-University Munich, project number: 17-087) and all contributing authors followed the ethical guidelines for publication in Archives of Gynecology and Obstetrics. All study data were gathered according to the principles expressed in the Declaration of Helsinki/Edinburgh 2002. Prior to each examination oral and written informed consent of all pregnant patients were given before CEUS examination and their associated risks and potential complications including yet non-described fetal adverse effects have been carefully described.

Informed consent

Informed consent of all included patients to participate in the clinical study during their medical care at our University Hospital was obtained. All included patients agreed that their data might anonymously be published in a scientific journal.

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Schwarze, V., Froelich, M.F., Marschner, C. et al. Safe and pivotal approaches using contrast-enhanced ultrasound for the diagnostic workup of non-obstetric conditions during pregnancy, a single-center experience. Arch Gynecol Obstet 303, 103–112 (2021). https://doi.org/10.1007/s00404-020-05735-8

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  • DOI: https://doi.org/10.1007/s00404-020-05735-8

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