Specialists' Decisions in Choosing Diagnostic Imaging Methods in Pregnant Patients with Multiple Traumas, 2024

Document Type : Original Article

Authors

1 Associate Professor, Department of Emergency Medicine, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

2 Emergency Medicine Specialist, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

3 Assistant Professor, Department of Surgery, Vascular Surgery Subspecialist, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

4 Associate Professor, Department of Obstetrics and Gynecology, Infertility Fellowship, Reproductive Health Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

5 Assistant Professor, Department of Radiology, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

6 PhD in Nursing Education, Guilan Road Trauma Research Center, Trauma Institute, Guilan University of Medical Sciences, Rasht, Iran.

7 Assistant Professor, Department of Emergency Medicine, Poursina Clinical Research Development Unit, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.

10.22038/ijogi.2025.85482.6330

Abstract

Introduction: Traumas are unpredictable injuries during pregnancy that are associated with high mortality and maternal and fetal injuries. Choosing the correct imaging modality in trauma of pregnant mothers is important to reduce the possible exposure of the fetus to ionizing radiation. The present study was conducted with aim to determine the decisions of experts in relation to choosing diagnostic imaging tools in pregnant patients with multiple traumas.
Methods: This prospective study was conducted in 2022 at Poursina Educational and Medical Center, Guilan Province. The three implementation stages were: determining experts using the snowball method, designing 18 comprehensive scenarios for pregnant women with multiple traumas, and voting on the best imaging modality in the proposed scenarios. The data collection tool in this study was descriptive scenario forms, and data analysis was conducted solely based on the clinical judgment and professional expertise of the selected experts; final results were extracted according to the greatest consensus or the average of their opinions.
Results: The use of plain radiography for limb injuries, ultrasound for abdominal injuries, and CT scan for head injuries are prioritized, and the use of intravenous contrast media is contraindicated in pregnant mothers as much as possible. The use of plain radiography for limb injuries, both upper and lower, was the first choice for diagnosis in pregnant women in a trauma center. In abdominal and pelvic injuries, ultrasound is prioritized over CT scan, and contrast media should not be used in pregnant women, especially in the first trimester, as much as possible. In head and neck injuries, CT scan is prioritized in cases requiring imaging. In the case of MRI in emergency cases and lack of time, it is not a suitable option and will be replaced by CT scan.
Conclusion: In the management of pregnant women with multiple traumas, after consulting with several specialists, an individualized treatment method with the least complications should be selected for the mother and fetus. This decision is made based on each patient's specific circumstances and type of trauma to achieve the best results and minimal damage. Collaboration between the obstetrics, surgical, and emergency teams is critical in this vital process.

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Main Subjects

References

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The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 28, Issue 9
November 2025
Pages 32-45

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