Abdominal pain in pregnancy: Difference between revisions
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**Quantitative beta hCG and pelvic US | **Quantitative beta hCG and pelvic US | ||
*Also consider beta hCG and pelvic US if concerned for spontaneous abortion | *Also consider beta hCG and pelvic US if concerned for spontaneous abortion | ||
*Consider pelvic exam to check for open cervical os, protruding products of conception | **Consider pelvic exam to check for open cervical os, protruding products of conception | ||
*Urinalysis | *Urinalysis | ||
Revision as of 05:10, 8 October 2018
Background
- Pregnant women are at risk for the same Abdominal Pathologies causing pain in all patients but also a few special issues.
Clinical Features
- Abdominal pain in patient with positive pregnancy test
Differential Diagnosis
Abdominal Pain in Pregnancy
The same abdominal pain differential as non-pregnant patients, plus:
<20 Weeks
- Ectopic pregnancy
- First trimester abortion
- Complete abortion
- Threatened abortion
- Inevitable abortion
- Incomplete abortion
- Missed abortion
- Septic abortion
- Round ligament stretching
- Incarcerated uterus
- Malposition of the uterus
>20 Weeks
- Labor/Preterm labor
- Placental abruption
- Placenta previa
- Vasa previa
- Uterine rupture
- Vaginal trauma
- HELLP syndrome
- Cholestasis of pregnancy
- Chorioamnionitis
- Incarcerated uterus
- Acute fatty liver of pregnancy
- Malposition of the uterus
- Placenta accreta
- Placenta increta
- Placenta percreta
Any time
- Hemorrhagic ovarian cyst
- Fibroid degeneration or torsion
- Ovarian torsion
- Constipation
Evaluation
- Must consider ectopic pregnancy in pregnant patient presenting with abdominal pain and no documented IUP
- Quantitative beta hCG and pelvic US
- Also consider beta hCG and pelvic US if concerned for spontaneous abortion
- Consider pelvic exam to check for open cervical os, protruding products of conception
- Urinalysis