Abdominal Pain In Pregnancy

Question 0

Cholecystitis or biliary colic – when during pregnancy? Location? Associated symptoms? Treatment

Answer 0

After first trimester; RUQ

Nausea/vomiting, anorexia, leukocytosis, fever (No infection/fever in biliary colic)

If biliary colic, treat with low-fat diet until postpartum;

if cholecystitis/biliary obstruction/pancreatitis – surgery

Question 1

Abdominal pain that can occur in any trimester? Location? Associated symptoms? Treatment?

Answer 1

Appendicitis

RLQ – in pregnancy, pain is Superior and lateral to McBurney’s point (Pyelonephritis.);

N/V, anorexia, leukocytosis, fever

Surgery regardless of gestational age

Question 2

Ovarian torsion – when during pregnancy? Location? Associated symptoms? Treatment

Answer 2

At 14 weeks or after delivery

Unilateral abdomen

Nausea/vomiting

Surgery. – Ovarian cystectomy if twisting results in reperfusion; otherwise oophorectomy

Question 3

Placental abruption – when during pregnancy? Location? Associated symptoms? Treatment

Answer 3

Second/third trimester

Persistent Midline /Uterine

Vaginal bleeding and abnormal fetal heart tracings

Delivery

Question 4

Ectopic pregnancy – when during pregnancy? Location? Associated symptoms? Treatment

Answer 4

First trimester

Unilateral pelvic/abdominal

Nausea/vomiting, syncope, spotting

Surgery or methotrexate

Question 5

Delay in diagnosis of appendicitis and third trimester may lead to?

Answer 5

Preterm labor for abortion

Question 6

Ovarian torsion most frequent complication of?

Answer 6

Ovarian cyst

Question 7

Unreliable test for placental abruption?

Answer 7

Ultrasound

Question 8

Pt with suspected pancreatitis – next diagnostic step?

Answer 8

Ultrasound