Pain In Pregnancy Flashcards
Chorioamnionitis
Pathogens: E.coli, strep, enterococcus faecalis
Risk of maternal and fetal life threatening septicaemia
Abdo pain, uterine tenderness, mat pyrexia/tachycardia, raised inflammatory markers, fetal distress
Hx of rupture of membranes
RF: prolonged labour, preterm labour, internal fetal monitoring, cervical examinations, UT/vaginal infection
Pyelonephritis
Higher likelihood of sac UTI in preg
Progesterone= dilation of urinary system
Physically: baby causes obstructive uropathy and urinary stasis
PC: unwell, fever, rigours, n+v, loin-groin pain, freq, dysuria
HELLP syndrome
Epigastric/RUQ pain + nausea and vomiting
Oft with pre-eclampsia
Haemolysis, Elevated Liver enzymes, Low Platelets
Complications: AKI, DIC, high morb + mort
Correct coagulopathy, neuroprotection, antihypertensives
Cure = delivery
Acute fatty liver of pregnancy
Sudden onset epigastric pain, anorexia, malaise, nausea, vomiting, diarrhoea, jaundice, mild htn, proteinuria
Raised BR, deranged liver enzymes, leukocytosis, thrombocytopenia, hypoglycaemia, coag defects, high Uric acid
CT/MRI, liver biopsy
Correct coagulopathy, electrolytes, deliver
Symphysis pubis dysfunction
Pain + discomfort in pelvic area, radiates to upper thighs or perineum, exacerbated by walking, increased by pressure on SP or compression of pelvis
Worsens with progression of pregnancy
Rx: analgesia, pelvic support braces, crutches
Seen in 3% pregnancies
Stretching of round ligament
Stretching of ligament due to increasing size of uterus and effects of progesterone = non specific abdo pain
Ligament: uterine horns -> deep inguinal ring -> labia majora
Braxton hicks contractions
Sporadic uterine contractions
Relieved by time, rest, warm bath/ shower, drinking water, changing activities
Labour
Painful regular contractions assoc with dilation and effacement of cervix and downward progression of the presenting part
