Common obstetric histories - Abdominal pain

Question 1

What would you want to ask about abdominal pain in an abstetric patient?

Answer 1

SOCRATES

Question 2

What are general questions you might want to ask about on systemic enquiry of an obstetric patient?

Answer 2

• Fever
• Sweats

Question 3

What obstetric questions would you want to ask about on systemic enquiry of an obstetric patient?

Answer 3

• Foetal movements
• COntractions/tightening
• PV loss
• Pre-eclampsia symtpoms

Question 4

What gynaecological symptoms would you want to ask about in an obstetric patient with abdominal pain?

Answer 4

• PV discharge
• PV bleeding

Question 5

What urological symptoms would you want to ask about in an obstetric patient with abdominal pain?

Answer 5

• Storage - frequency, nocturia, urgency, volume
• Infection - dysuria, haematuria, odour

Question 6

What gastrointestinal symtpoms woud you ask about on systmic enquiry in an obstetric patient with abdominal pain?

Answer 6

• Weight loss
• Appetite change
• Vomiting/haematemesis
• Bowel habit change
• Tenesmus
• Blood/mucus in stool

Question 7

What features of abdominal pain in an obstetric patient would suggest PID/acute salpingitis?

Answer 7

• PV discharge
• Bilateral pelvic pain
• Vaginal discharge
• Dyspareunia
• Dysmenorrhoea
• FEver
• May have post-coital/intermenstrual bleeding

Question 8

What features assocaited with abdominal pain in an obstetric patient suggest an ectopic pregnancy?

Answer 8

• Unilateral pain + PV bleeding
• Usually between 4-12 weeks gestation

Question 9

What features of abdominal pain in an obstetric patient would suggest a miscarriage?

Answer 9

• <24 weeks gestation
• Associated PV bleeding
• May pass clots or products of conception

Question 10

What features of abdominal pain in an obstetric patient suggest braxton hicks contractions?

Answer 10

• Late pregnancy
• Infrequent
• Ireegular contractions

Question 11

What features of abdominal pain in an obstetric patient suggest labour as a cause?

Answer 11

• > 24 weeks gestation
• Painful regular contractions

Question 12

What are features of abdominal pain suggest fibroids (red degeneration or torsion) in an obstetric patient?

Answer 12

• Severe abdominal pain
• May have fever/vomiting

Question 13

What are features of abdominal pain in an obstetric patient suggests Ovarian torsion/haemorrhage/rupture?

Answer 13

• Severe unilateral pain
• May have fever/vomiting

Question 14

What are obstetic causes of abdominal pain in an obstetric patient?

Answer 14

• Ectopic
• Miscarriage
• Braxton hicks contractions
• Labour
• Placental abruption
• Pre-eclampsia
• Uterine rupture
• Chorioamnionitis

Question 15

What are gynaecological causes of abdominal pain in an obstetric patient?

Answer 15

• Fibroids - red degeneration/torsion
• PID
• Ovarian torsion/rupture/haemorrhage
• Round ligament pain
• Symphysis pubis dysfucntion

Question 16

What are general surgical causes of abdominal pain in an obstetric patient?

Answer 16

Any cause of acute abdominal pain in non-pregnant patients