Pelvic free fluid: clinical importance for reproductive age women with blunt abdominal trauma

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Abstract
Objective: To evaluate the importance of isolated pelvic free fluid (FF) detected by ultrasound examination in pregnant patients and in non‐pregnant reproductive age women with blunt abdominal trauma (BAT).Methods: Reproductive age women aged 10–50 years who presented with BAT and underwent focused abdominal sonography for trauma (FAST) from January 1995 to June 2002 at a Level 1 trauma center were included. Patients were assigned to four groups according to the location of FF detected by ultrasound (Group 1, no FF; Group 2, FF in pelvis; Group 3, FF in abdomen; Group 4, FF in abdomen and pelvis). Ultrasound findings were compared with intra‐abdominal and pelvic injuries detected by computed tomography and/or laparotomy. Pair‐wise comparison was performed using a Fisher's exact test.Results: Ultrasound detection of FF in the abdomen alone or FF in the abdomen and pelvis was significantly associated with intra‐abdominal injury (IAI) compared to those without FF (P < 0.001) for both pregnant and non‐pregnant reproductive age women. FF isolated to the pelvis was also associated with a higher injury rate compared to no FF in pregnant women (30% vs. 3%, P = 0.005) and in non‐pregnant reproductive age women (39.5% vs. 3.7%, P < 0.001).Conclusions: In reproductive age women with BAT, ultrasound detection of FF in the abdomen alone, in both the abdomen and pelvis, or isolated to the pelvis is associated with a higher IAI rate. Therefore, isolated FF in the pelvis should not necessarily be considered physiological in pregnant and non‐pregnant patients with BAT. Copyright © 2005 ISUOG. Published by John Wiley & Sons, Ltd.

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