E1503. Imaging of Suspected Cardiothoracic Complications of the 4th Trimester
  1. Miltiadis Tembelis; NYU Langone Hospital - Long Island
  2. Douglas Katz; NYU Langone Hospital - Long Island
  3. Margarita Revzin; Yale School of Medicine
The post-partum/peri-partum/puerperium period, which has recently been labeled as the ‘4th trimester’, shares some conditions/disorders in common with pregnancy, but also has its own series of potential complications and problems. Special consideration for imaging safety must also be taken into account in this patient population. A thorough knowledge of potential complications during the fourth trimester can help radiologist make timelier and more accurate diagnoses.

Educational Goals / Teaching Points
Review several potential disorders of the thorax/cardiovascular system in the post-partum period where imaging plays a role in identification and in steering appropriate therapy. To demonstrate imaging examples of cardiothoracic/cardiovascular complication during pregnancy as well as the post-partum period. To discuss algorithms and safety considerations.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Cases discussed include pulmonary edema, Eclampsia/pre-eclampsia (primarily the gestational period), pneumonia, PE/DVT, amniotic fluid emboli, cardiomyopathy, miscellaneous rare conditions/disorders (SCAD, aortic dissection). Imaging techniques include cardiac and non-cardiac computed tomography, cardiac magnetic resonance imaging, intravascular ultrasound and radiography.

There are several conditions and disorders that may affect the chest and cardiovascular system in pregnant and post-partum women. Some of these are relatively common (edema, PE/DVT), and others are relatively rare (AFE, SCAD). Radiologist awareness of these potential disorders associated with the ‘4th trimester’ is important for timely diagnosis and appropriate patient management.