Abstract
Background and objectives: Native ultrasound is the most common imaging modality in obstetrics. The use of contrast-enhanced ultrasound (CEUS) during pregnancy has not been officially approved by leading societies for obstetrics and ultrasound. The present study aims to monitor the safety and diagnostic performance of CEUS for assessing abdominal issues in five pregnant women. Materials and Methods: Five pregnant patients who underwent a total of 11 CEUS examinations between June 2020 and October 2020 were included (mean age: 34 years; mean time of pregnancy: 21 weeks). All CEUS scans were interpreted by one experienced consultant radiologist (EFSUMB Level 3). Results: Upon contrast application, no maternal nor fetal adverse effects were observed. Moreover, no fetal contrast enhancement was observed in any patient. CEUS helped to diagnose renal angiomyolipoma, pyelonephritis, necrotic uterine fibroid, gallbladder polyp, and superior mesenteric vein thrombosis. Conclusions: In our study, off-label use of CEUS showed an excellent safety profile allowing the avoidance of ionizing radiation exposure as well as contrast agents in case of CT or use of gadolinium-based contrast agents in case of MRI. CEUS is a promising diagnostic instrument for facilitating clinical decision-making and improving the management of pregnant women.
Highlights
Ultrasound is the most frequently used imaging modality in obstetrics
Due to the lack of substantial evidence of gadolinium’s safety in pregnancy, the American College of Radiology (ACR) Committee on Drugs and Contrast Media recommends the intravenous application of gadolinium-based contrast agents (GBCAs) only when “potential benefits justify the potential unknown risk of the fetus” [21]
Up until now, the application of contrast-enhanced ultrasound (CEUS) during pregnancy has not been officially approved by leading societies for obstetrics and ultrasound due to concerns about potential related adverse effects [30]
Summary
The local institutional ethical committee of the institutional review board (Ethics Committee, Medical Faculty, Ludwig-Maximilians-University Munich; 17-087; date of approval: 14 March 2017). All CEUS examinations were performed and interpreted by an experienced consultant radiologist (EFSUMB Level 3) using an up-to-date high-end ultrasound device (Philips EPIQ 7, transducer C5-1, Seattle, Washington, DC, USA) and appropriate CEUS protocols. Oral and written informed consent of all women included in the study was obtained before the examination. Fetal cardiac activity and fetal movement were assessed by B-mode and Color Doppler before and after each contrast-enhanced examination. CEUS scans were performed using a second-generation blood pool contrast agent (SonoVue® , Bracco, Milan, Italy). A bolus of 1.5–2.4 mL of SonoVue® was injected intravenously, followed by 5–10 mL of sterile 0.9%. No maternal or fetal adverse side effects upon intravenous application of SonoVue® were registered. We included a total of five pregnant women in our single-center study who underwent a total of
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