Abdominal pain in pregnancy

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 pathologies as non-pregnant patients, plus:

<20 Weeks

>20 Weeks

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
  • 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