Abdo Pain Flashcards
What are causes of abdominal pain in early pregnancy?
Ectopic pregnancy
Miscarriage
What are causes of abdo pain in late pregnancy?
Labour Placental abruption Symphysis pubis dysfunction Pre-eclampsia/HELLP syndrome Uterine rupture
Uteirne fibroids Uterine torsion Appendicitis Cholecystitis Rectus sheath haematoma Pancreatitis UTI Gastroenteritis
How does ectopic pregnancy present?
6-8 weeks amnenorrhoea
Lower abdominal pain - constant, may be unilateral
Vaginal bleeding - less than normal period
Peritoneal bleeding can cause shoulder tip pain and pain on defaecation/urination
How do stages of miscarriage present?
Threatened:
Painless Vaginal bleeding
Cervical os closed
Missed:
Gestational sac contains dead fetus before 20 weeks without symptoms of expulsion
Light vaginal bleeding/discharge
Symptoms of pregnancy disappear
Inevitable
Vaginal bleeding
Cramping abdominal apin
Cervical os open - products not yet passed
Incomplete Heavy and increased vaginal bleeding Intense lower abdo pain Passage of some products Cervical os open - products present
Complete
Products of conception passed
Cervical os closed
How does placental abruption present
Abdo pain
Uterine rigidity
Vaginal bleeding
Separation of normally sited placenta from uterine wall - maternal haemorrhage
Shock out of keeping with visible loss
Tender, tense uterus
Pain constant
Fetal heart absent/distressed
Beware DIC, PPH
How doe symphysis pubis dysfunction present?
Ligament laxity increases in response to hormonal changes of pregnancy
Pain over pubic symphysis with radiation to the groins and the medial aspects of the thighs
Waddling gait
How does pre-eclampsia and HELLP syndrome present?
Hypertension
Proteinuria
RUQ/Epigastric pain
Haemolysis
Elevated liver enzymes
Low platelet count
How does uterine rupture present?
Maternal shock
Abdo pain
Vaginal bleeding
How does appendicitis present?
Location of appendix migrates upwards, outwards and posteriorly as pregnancy progresses
RLQ pain is still commonest
Tenderness, rebound and guarding less ovious
How does cholecystitis present?
Pregnancy encourages gallstone formation due to biliary stasis and increased cholesterol in bile
Subcostal pain
Nausea/vomiting
Jaundice is uncommon
Laprarscopic cholecystectomy can be safe but miscarriage/preterm labour is a risk
How does rectus sheath haematoma present?
Bleeding into rectus sheath and Haematoma formation can occur with coughing in late pregnancy causing swelling and tenderness
