Liina Poder

Primary amenorrhea reflects disruption along the hypothalamic-pituitary-ovarian-uterine axis; may arise from anatomic, genetic, or functional abnormalities; and may be diagnosed on the basis of US and MRI findings.

Postpregnancy hemorrhage is a significant cause of maternal morbidity and can be the result of subinvolution of the placental site or retained or residual products of conception, and enhanced myometrial vascularity, which may be physiologic or associated with these causes, should not be confused with arteriovenous malformations or other vascular anomalies.

The spectrum of abnormalities associated with endometriosis necessitates a pattern-based, systematic approach that includes diagnosis with dedicated US and MRI protocols to optimize treatment outcomes and effectively communicate with patients and referring physicians.

The Society of Radiologists in Ultrasound expert consensus provides recommendations for augmenting routine pelvic US examinations through additional maneuvers and imaging to improve diagnosis of deep endometriosis.

Amniotic fluid (AF) is an integral part of the fetal environment and is essential for fetal growth and development. Pathways of AF recirculation include the fetal lungs, swallowing, absorption through the fetal gastrointestinal tract, excretion through fetal urine production, and movement. In addition to being a marker for fetal health, adequate AF is necessary for fetal lung development, growth, and movement. The role of diagnostic imaging is to provide a detailed fetal survey, placental evaluation, and clinical correlation with maternal conditions to help identify causes of AF abnormalities and thereby enable specific therapy. Oligohydramnios prompts evaluation for fetal growth restriction as well as genitourinary issues, including renal agenesis, multicystic dysplastic kidneys, ureteropelvic junction obstruction, and bladder outlet obstruction. Premature preterm rupture of membranes should also be clinically excluded as a cause of oligohydramnios. Clinical trials evaluating amnioinfusion are underway as a potential intervention for renal causes of oligohydramnios. Most cases of polyhydramnios are idiopathic, with maternal diabetes being a common cause. Polyhydramnios prompts evaluation for fetal gastrointestinal obstruction and oropharyngeal or thoracic masses, as well as neurologic or musculoskeletal anomalies. Amnioreduction is performed only for maternal indications such as symptomatic polyhydramnios causing maternal respiratory distress. Polyhydramnios with fetal growth restriction is paradoxical and can occur with maternal diabetes and hypertension. When these maternal conditions are absent, this raises concern for aneuploidy. The authors describe the pathways of AF production and circulation, US and MRI assessment of AF, disease-specific disruption of AF pathways, and an algorithmic approach to AF abnormalities. ^©RSNA, 2023 Online supplemental material is available for this article. Quiz questions for this article are available through the Online Learning Center.

The workup of cancer in pregnancy, while balancing both maternal prognosis and fetal well-being, is dependent on diagnostic imaging findings to guide complex multidisciplinary management. Pregnancy-associated cancer (PAC) is defined as cancer that is detected during pregnancy and up to 1 year postpartum. Although rare (~1:1000 pregnancies), PAC is increasing owing to postponed child...

US and MRI are essential to classifying müllerian duct anomalies and identifying commonly associated urinary tract anomalies. Müllerian duct anomalies (MDAs) have important implications for the reproductive health of female patients. In patients with both infertility and recurrent pregnancy loss, the incidence of MDAs is ...

US-guided interventions have an essential role in the diagnosis and treatment of obstetric and gynecologic pathologic conditions, and knowledge of abnormal imaging findings, the limitations of thes... US-guided procedures have an essential role in the diagnosis and treatment of multiple obstetric and gynecologic conditions, can be performed with either transvaginal or transabdominal approaches, ...