What Every Radiologist Should Know: Second and Third Trimester (Covers Beyond the Fetus) (2025)-W1-COB07-2025

Video Transcription

Video Summary

The transcript covers key “non-fetal” pregnancy emergencies and how radiologists should communicate actionable findings. Three urgent obstetric diagnoses are highlighted: oligohydramnios, short cervix, and vasa previa. For low amniotic fluid, early onset is most concerning; it may reflect serious fetal compromise and warrants a phone call. Current guidance favors the single maximum vertical pocket (MVP) over AFI to avoid overcalling borderline cases, and color Doppler helps avoid mistaking cord for fluid.<br /><br />Short cervix is best assessed transvaginally; <25 mm in mid-gestation predicts preterm birth and may prompt vaginal progesterone or cerclage, so technique and reporting (funneling, sludge) matter. Vasa previa—fetal vessels over/near the internal os—requires routine color Doppler with low-lying placenta, velamentous cord insertion, or accessory lobes; prenatal detection dramatically improves survival.<br /><br />The talk then addresses abdominal pain in pregnancy: appendicitis (often displaced), renal stones, and especially pyelonephritis; ultrasound first, but MRI or CT is acceptable when necessary, as radiation doses are typically below harmful thresholds.<br /><br />Later sections review malignancy in pregnancy (MRI safe without gadolinium; diffusion as surrogate), NIPT abnormalities revealing occult maternal cancer, and placenta accreta spectrum imaging, emphasizing ultrasound screening, MRI for extent, structured reporting, and multidisciplinary planning to prevent maternal deaths.

Keywords

oligohydramnios

single maximum vertical pocket (MVP)

short cervix

vasa previa

color Doppler obstetric ultrasound

abdominal pain in pregnancy imaging

MRI in pregnancy (no gadolinium)

placenta accreta spectrum