Abdominal pain in the postpartum: role of imaging

The post-delivery evaluation of the obstetric patient presenting with severe abdominal pain can be a challenge to the obstetrician, the internist, and the radiologist. Besides non-pregnancy-related causes of abdominal pain, several pregnancy-related complications should be included in the list of differential diagnoses. Based on pathogenesis, these conditions can be divided in four categories: thromboembolic disease, infectious complications, mechanical complications, and complications of preeclampsia. Most disease processes can be adequately visualized with sonography. CT can be indicated for the evaluation of the extent of ovarian vein thrombosis and for depiction of deep abdominal collections in obese patients or in cases of abundant overlying abdominal gas. MRI can be useful to provide the specific diagnosis of hemorrhagic liver infarction in the clinical setting of a HELLP syndrome.