Musculoskeletal Injuries in Pregnancy

Abstract

Abstract Trauma is the most common cause of non-obstetric death among pregnant patients. Common causes of trauma in pregnant patients include falls, motor vehicle accidents, and domestic violence. In addition, pregnant patients present to the Emergency Department with a wide range of musculoskeletal injuries, due in part to physiologic and hormonal changes of pregnancy and altered biomechanics, which predispose patients to pubic symphysis diastasis, diastasis recti, tendinopathy, sciatica, carpal tunnel syndrome, insufficiency or stress fractures, and femoral head osteonecrosis. Several imaging modalities may be employed for evaluation during pregnancy. Ultrasound is valuable because of its lack of ionizing radiation and its utility in assessing fetal status, and it can also be used to evaluate the soft tissues of the extremities. Computed tomography (CT) is the most accurate and cost-effective tool in assessment of maternal trauma. Radiography, fluoroscopy, and CT expose the mother and fetus to ionizing radiation, and consideration of radiation dose and imaging risks/benefits is vital. Magnetic resonance imaging can be employed to evaluate spinal, occult osseous, and soft tissue injuries.