Role of Ultrasound in Assessing and Diagnosing Pelvic Pain in Pregnancy

Pelvic pain (PP) is a common complaint among pregnant women, which may arise due to several diseases, including obstetrics, gynecological, gastrointestinal, genitourinary, and vascular disorders. Timely and accurate diagnosis and prompt treatment are essential for the well-being of the mother and fetus. However, these remain very challenging. 

Physicians must acknowledge that the physiological changes during pregnancy may confuse the diagnosis. In this setting, ultrasound (US) should be used as the first-line imaging technique since it is readily and widely available and does not use ionizing radiation. In some cases, US may be conclusive for the diagnosis (e.g., if it detects no fetal cardiac activity in suspected spontaneous abortion; if it displays an extrauterine gestational sac in suspected ectopic pregnancy; or demonstrates a dilated, aperistaltic, and blind-ending tubular structure emerging from the cecum in suspicious of acute appendicitis). Magnetic resonance imaging (MRI) can overcome some limits of the US and represents the second-line imaging technique when the US is negative or inconclusive. It can help detect the cause of bowel obstruction or to illustrate adnexal masses.

Caruso M, Dell’Aversano Orabona G, Di Serafino M, Iacobellis F, Verde F, Grimaldi D, Sabatino V, Rinaldo C, Schillirò ML, Romano L. Role of Ultrasound in the Assessment and Differential Diagnosis of Pelvic Pain in Pregnancy. Diagnostics. 2022; 12(3):640. https://doi.org/10.3390/diagnostics12030640