Abdominal

Abdominal Pain
Pain in
in
Pregnancy
Pregnancy
Max Brinsmead MB BS PhD
May 2015
 Differential Diagnosis

• Physiological

• Pregnancy-related Pathology

• Unrelated to Pregnancy
 Physiological Causes of
Abdominal Pain
• The corpus luteum
• Round ligament pain
• Ureteric obstruction
• Nerve entrapment
• Constipation and colic
• Symphyseal separation
• Acid reflux & oesophagitis
• Umbilical skin stretching
Pregnancy Related
Pathology
• Ectopic gestation
• Placental bleeding –
• ie miscarriage & abruption
• Premature labour
• Severe pre eclampsia
• Ovarian cyst complication
• Tubal torsion
• Fibroid degeneration
• Uterine rupture
Abdominal Pain Unrelated
to Pregnancy
• Appendicitis
• (PID)
• Urinary tract infection/stone
• Cholecystitis and biliary colic
• Pancreatitis
• Splenic artery rupture
• Volvulus sigmoid/Caecum
 Dimensions in
Management
• Maternal anxiety
– And also that of family

• Pregnancy physiology
– Alters symptoms, signs and laboratory tests

• Therapeutic paralysis
– Medical
– Surgical
 Current Controversies
• Role of laparoscopy
– Diagnostic
– Therapeutic

• Risk of Pre term labour

– A role for tocolysis?
 Any
Any Questions
Questions or
or
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