Abdominal pain in pregnancy: Difference between revisions
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==Background== | ==Background== | ||
[[File:Bumm 123 lg - Copy.jpg|thumb|Estimated gestational age based on physical exam.]] | [[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 | *Pregnant women are at risk for the same general [[Special:MyLanguage/Abdominal Pain|abdominal pathologies]] in addition to unique complications associated with pregnancy | ||
==Clinical Features== | ==Clinical Features== | ||
*Abdominal pain in patient with positive pregnancy test | *Abdominal pain in patient with positive pregnancy test | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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{{Abdominal Pain Pregnancy DDX}} | {{Abdominal Pain Pregnancy DDX}} | ||
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==Evaluation== | ==Evaluation== | ||
*Must consider [[ectopic pregnancy]] in pregnant patient presenting with abdominal pain and no documented IUP | |||
**Quantitative [[beta hCG]] and [[pelvic US]] | *Must consider [[Special:MyLanguage/ectopic pregnancy|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 | **Quantitative [[Special:MyLanguage/beta hCG|beta hCG]] and [[Special:MyLanguage/pelvic US|pelvic US]] | ||
**Consider [[pelvic exam]] to check for open cervical os, protruding products of conception | *Also consider [[Special:MyLanguage/beta hCG|beta hCG]] and [[Special:MyLanguage/pelvic US|pelvic US]] if concerned for spontaneous abortion | ||
*[[Urinalysis]] | **Consider [[Special:MyLanguage/pelvic exam|pelvic exam]] to check for open cervical os, protruding products of conception | ||
*[[Special:MyLanguage/Urinalysis|Urinalysis]] | |||
*CBC, CMP, lipase, abdominal imaging depending on the differential | *CBC, CMP, lipase, abdominal imaging depending on the differential | ||
==Management== | ==Management== | ||
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==Disposition== | ==Disposition== | ||
===Admit=== | ===Admit=== | ||
*Ruptured [[ectopic pregnancy]] | |||
*[[delivery|Active labor]] | *Ruptured [[Special:MyLanguage/ectopic pregnancy|ectopic pregnancy]] | ||
*[[Preeclampsia]]/[[HELLP]] | *[[Special:MyLanguage/delivery|Active labor]] | ||
*[[Placental abruption]] | *[[Special:MyLanguage/Preeclampsia|Preeclampsia]]/[[Special:MyLanguage/HELLP|HELLP]] | ||
*[[Uterine rupture]] | *[[Special:MyLanguage/Placental abruption|Placental abruption]] | ||
*[[Ovarian torsion]] | *[[Special:MyLanguage/Uterine rupture|Uterine rupture]] | ||
*[[Special:MyLanguage/Ovarian torsion|Ovarian torsion]] | |||
*Surgical abdomen | *Surgical abdomen | ||
===Discharge=== | ===Discharge=== | ||
*[[Ectopic pregnancy]] if hemodynamically stable with OB follow-up | |||
*[[Spontaneous abortion]] if hemodynamically stable with adequate pain control | *[[Special:MyLanguage/Ectopic pregnancy|Ectopic pregnancy]] if hemodynamically stable with OB follow-up | ||
*[[Special:MyLanguage/Spontaneous abortion|Spontaneous abortion]] if hemodynamically stable with adequate pain control | |||
==See Also== | ==See Also== | ||
*[[Abdominal Pain]] | |||
*[[Pregnancy (main)]] | *[[Special:MyLanguage/Abdominal Pain|Abdominal Pain]] | ||
*[[Special:MyLanguage/Pregnancy (main)|Pregnancy (main)]] | |||
==External Links== | ==External Links== | ||
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==References== | ==References== | ||
<references/> | <references/> | ||
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[[Category:GI]] | [[Category:GI]] | ||
[[Category:Symptoms]] | [[Category:Symptoms]] | ||
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Revision as of 21:31, 4 January 2026
Background
- 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
- 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
- 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
- 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