Abdominal pain in pregnancy: Difference between revisions
 
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*Pregnant women are at risk for the same [[Abdominal Pain|Abdominal Pathologies ]] causing pain in all patients but also a few special issues.
==Background==
[[File:Bumm 123 lg - Copy.jpg|thumb|Estimated gestational age based on physical exam.]]
*Pregnant women are at risk for the same general [[Abdominal Pain|abdominal pathologies]] in addition to unique complications associated with pregnancy


==Pregnancy Specific Differential==
==Clinical Features==
*[[Ectopic Pregnancy]]
*Abdominal pain in patient with positive pregnancy test
*[[Pelvic Inflammatory Disease]] is less likely due to mucus plug of pregnancy unless preexisting prior to pregnancy
 
*[[Tubo-Ovarian Abscess]] is also unlikely unless existing prior to pregnancy
==Differential Diagnosis==
*[[Septic abortion]]
{{Abdominal Pain Pregnancy DDX}}
*[[HELLP Syndrome]]
 
*[[Chorioamnionitis]]
==Evaluation==
*[[Heterotopic Pregnancy]] especially if fertility enhancement was used
*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]]
*CBC, CMP, lipase, abdominal imaging depending on the differential
 
==Management==
 
 
==Disposition==
===Admit===
*Ruptured [[ectopic pregnancy]]
*[[delivery|Active labor]]
*[[Preeclampsia]]/[[HELLP]]
*[[Placental abruption]]
*[[Uterine rupture]]
*[[Ovarian torsion]]
*Surgical abdomen
 
===Discharge===
*[[Ectopic pregnancy]] if hemodynamically stable with OB follow-up
*[[Spontaneous abortion]] if hemodynamically stable with adequate pain control


==See Also==
==See Also==
*[[Abdominal Pain]]
*[[Abdominal Pain]]
*[[Pregnancy (main)]]
==External Links==
==References==
<references/>


[[Category:OB/GYN]]
[[Category:OBGYN]]
[[Category:GI]]
[[Category:GI]]
[[Category:Symptoms]]

Latest revision as of 12:20, 25 November 2021

Background

Estimated gestational age based on physical exam.
  • Pregnant women are at risk for the same general abdominal pathologies in addition to unique complications associated with pregnancy

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

>20 Weeks

Any time

Evaluation

  • Must consider ectopic pregnancy in pregnant patient presenting with abdominal pain and no documented IUP
  • 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
  • CBC, CMP, lipase, abdominal imaging depending on the differential

Management

Disposition

Admit

Discharge

See Also

External Links

References

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