Ultrasound in firearm injuries in pregnancy.

Objective: We aimed to evaluate the subject of using diagnostic ultrasound and other radiological methods for firearm injury in pregnant women The military conflicts and terrorism terrorism is on the rise in our times. Mass casualty situations are encountered more frequently, nowadays, involving civilians and also pregnant women, therefore injuries with military weapons tend to increase in daily practice, with another increasing contribution being the violence against women using firearms. Methods: The literature on the subject was searched using Clinical Keys® and PubMed®. The evaluation of firearm injuries during pregnancy is critical. The extent of the injury and fetal involvement should be well evaluated and documented. The projectile should be identified, localized and recovered for ballistic investigation. Results: There are limited literature on the subject. However some guidelines are formed. In the pregnant trauma patient, ultrasound is often easily accessible in an emergency department and can provide crucial information. Conclusion: Although ultrasound is the primary tool of diagnosis for obstetricians, additional radiological investigations including computer tomography or plain X rays may aid in diagnosis, and should be ordered without hesitation when necessary, especially in life threathening conditions involving high speed penetrating projectile injuries to the abdomen. As stated in the guidelines(2):"Concern about possible effects of highdose ionizing radiation exposure should not prevent medically indicated maternal diagnostic X-ray procedures from being performed. During pregnancy, other imaging procedures not associated with ionizing radiation should be considered instead of X-rays when possible." Viability of the fetus can also be assessed and documented using fetal biometry and possible vascular injuries to both fetus and placenta can be assessed by using color doppler. 3D/4D ultrasound may also be utilized to surface scan the fetus for any possible injury when there is suspected uterine penetrating injury, this is of course, when the mother and fetus is stable. It should be remembered that ultrasound is unreliable for detecting placental abruption but it may be helpful to exclude placenta previa and demonstrate significant hemorrhage. [ABSTRACT FROM AUTHOR]