NEW YORK (Reuters Health) – In pregnant women with acute trauma, computed tomography accurately identifies placental abruption, Arizona researchers report.

Up to 40% of pregnant women with severe trauma and as many as 5% with minor trauma will have placental abruption, lead author Dr. Maria Manriquez and her colleagues say.

The researchers, all from the Maricopa Integrated Health System in Phoenix, reviewed CT scans and clinical data on 61 pregnant trauma patients, most of whom had been injured in vehicular accidents.

According to their March 7th online paper in the American Journal of Obstetrics & Gynecology, seven women had signs of abruption on their CT scans (i.e., retroplacental hematoma, separation of placenta, or decreased placental enhancement). Seven women delivered within 36 hours of trauma, including six of those with positive scans.

Using delivery within 36 hours as a clinical marker of placental abruption, CT evaluation had a sensitivity of 86%, a specificity of 98% and an overall accuracy of 96%.

The authors report that CT “correctly identifies placental abruption with sensitivity equal to or greater than that of ultrasound.”

Dr. Manriquez told Reuters Health by email that radiologists “should…give a qualitative statement or summary of significant findings of the placental status when a CT is obtained of the pregnant uterus.”

She added, “In the clinical setting of an abnormal placental finding… the practitioner may choose to monitor the fetus more closely.”

Reference:
Am J Obstet Gynecol 2010.