Errors in Imaging of Emergencies in Pregnancy

Errors in imaging the pregnant patient with acute abdomen

“…Radiological errors are part of this second group. To our knowledge, the current literature does not report radiological error percentages in general but states that there is a daily risk of approximately 4% of radiologic mistakes [2][3][4][5][6]. The cause of a radiological error is generally multifactorial depending both on the Radiologist directly and other contributory factors, according to this assertion, a practical classification of radiological errors is reported in Table 1 [2,3].…”

“…This is an observer error due to the Radiologist's lack of attention for unrelated findings in the presence of a specific diagnostic question. than 20 studies a day, whereas the availability of accurate and correct clinical information have been reported to improve the accuracy of the reports to 83% [5]. On the other hand, individual experience and knowledge of the staff play an important role in the occurrence of an error [3,4].…”

“…The Radiologist has in fact to choose the appropriate imaging method for the suspected diagnosis, to perform a proper examination in terms of technical execution and to correctly interpret the images [4]. This is particularly difficult in emergencies, when a decision has to be made in a short time and in difficult environmental conditions and in the case of some infrequent conditions, such as gynecological or non-gynecological emergencies, the poor experience of the Radiologist can make patient management more complicated [5]. An acute abdomen in pregnancy represents one of the most challenging diagnostic and therapeutic dilemmas in the emergency setting; however, a related percentage of errors has never been reported [5].…”

“…This is particularly difficult in emergencies, when a decision has to be made in a short time and in difficult environmental conditions and in the case of some infrequent conditions, such as gynecological or non-gynecological emergencies, the poor experience of the Radiologist can make patient management more complicated [5]. An acute abdomen in pregnancy represents one of the most challenging diagnostic and therapeutic dilemmas in the emergency setting; however, a related percentage of errors has never been reported [5]. The difficulty is due to the anatomical and pathophysiological changes related to pregnancy, such as the different locations of abdominal and pelvic structures, displaced by the uterus, altered laboratory tests (e.g., basal leukocytosis ranging from 5,000 to 16,000/mm 3 in the second and third trimesters and up to 25,000-30,000/mm 3 in premature labor) [7], difficult abdomen examination and non-specific symptoms [8].…”

“…However, it is important to be aware that, often, risk to the fetus is perceived to be higher than it actually is [11] and that any delay in the diagnosis can seriously endanger both the mother and the fetus [7]. Pathologies that can affect the pregnant woman and the fetus, may be of gastrointestinal, gynecologic, urologic, or obstetric nature and can present symptoms, such as nausea, vomiting, abdominal pain, altered bowel movement, and constipation, which are non-specific, common in pregnancy and difficult to recognize as abnormal [5,12]. For this reason, an imaging exam is frequently required to help in the diagnosis [13].…”