E2593. Postpartum Complications After Cesarean Delivery: A Multimodality and Pictorial Approach
  1. Sameer Sandhu; Emory University School of Medicine
Cesarean delivery is one of the most frequent abdominal surgeries performed in women. Although it is a safe procedure, the procedure is associated with a variety of acute and chronic complications. Imaging plays a crucial role in identifying the complications via a multimodality approach using ultrasound, CT and MRI. Therefore, it is imperative for the radiologist to be familiar with normal postoperative findings following cesarean delivery which is necessary to recognize the acute and chronic complications. Prompt recognition of the various pathologic conditions is crucial to alert clinicians and guide appropriate maternal and fetal management.

Educational Goals / Teaching Points
Discuss the surgical technique of Cesarean delivery. Illustrate normal expected postoperative findings after Cesarean delivery. Illustrate the various acute and chronic imaging complications after Cesarean delivery via a multimodality approach. Briefly discuss management of the complications.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Surgical technique (skin incision, separation of rectus muscle layer, creation bladder flap, hysterotomy, uterine closure). Acute complications after Cesarean delivery (endometritis, wound infection, abscess, subfascial vs bladder flap hematoma, uterine dehiscence, uterine rupture, ovarian/pelvic thromphophlebitis, uterine artery pseudoaneurysm, uterine arteriovenous malformation). Chronic complications after Cesarean delivery (C section scar ectopic pregnancy, C section scar endometriosis, C section scar niche, displaced intrauterine device, placenta accreta).

Given the increasing frequency of Cesarean section, radiologists play a key role in identifying both acute and chronic complications. Although it is a relatively safe procedure, there can be significant morbidity and mortality if prompt recognition of various complications does not occur. By recognizing both the normal and abnormal imaging findings after Cesarean delivery, a radiologist guides the clinicians in determining the next step in management.