Abdominal_pain_in_pregnancy_flashcards
How can abdominal pain in pregnancy be categorized?
Early, late, or at any point during pregnancy.
What is the most important cause of abdominal pain to exclude in early pregnancy?
Ectopic pregnancy.
What percentage of all pregnancies are ectopic?
0.5%.
What are the risk factors for ectopic pregnancy?
Damage to tubes (salpingitis, surgery), previous ectopic, IVF.
Describe a typical history for ectopic pregnancy.
A history of 6-8 weeks amenorrhoea with lower abdominal pain and later vaginal bleeding.
What are the symptoms of ectopic pregnancy?
Lower abdominal pain (constant, unilateral) and vaginal bleeding (less than normal period, may be dark brown).
What can peritoneal bleeding cause in ectopic pregnancy?
Shoulder tip pain and pain on defecation/urination.
What is a threatened miscarriage?
Painless vaginal bleeding before 24 weeks, typically at 6-9 weeks, with a closed cervical os.
What is a missed (delayed) miscarriage?
A gestational sac containing a dead fetus before 20 weeks without symptoms of expulsion, sometimes described as ‘blighted ovum’ or ‘anembryonic pregnancy’.
What is an inevitable miscarriage?
Open cervical os with heavy bleeding and pain.
What is an incomplete miscarriage?
Not all products of conception have been expelled.
What is a common cause of abdominal pain in late pregnancy?
Labour.
What is placental abruption?
Separation of a normally sited placenta from the uterine wall, causing maternal hemorrhage.
What are the clinical features of placental abruption?
Shock out of keeping with visible loss, constant pain, tender and tense uterus, normal lie and presentation, fetal heart absent/distressed, coagulation problems.
What is symphysis pubis dysfunction?
Ligament laxity causing pain over the pubic symphysis with radiation to the groins and medial thighs, and a waddling gait.
