Obstetrics Simplified - Diaa M. EI-Mowafi
Abdominal Pain with Pregnancy
Pregnancy Related Pain
Abortion: Inevitable, incomplete or septic abortions.
Vesicular mole: when expulsion starts.
Ectopic pregnancy: pain precedes bleeding.
Mid-trimester abortion: although
abortion due to cervical incompetence is relatively painless it
may be preceded by mild lower abdominal pain.
Angular pregnancy ; or rupture of
a rudimentary horn.
Red degeneration of fibroids.
Stretch of the nerve fibres in the
round ligaments: pain in one or both iliac fossae between 16th and
20th week of pregnancy.
Severe pre-eclampsia: associated with upper abdominal
Pressure symptoms: as engagement of the head,
distension of the abdominal wall and pain due to flaring of the
ribs particularly in breech presentation.
Braxton Hicks contractions: Although it is usually
painless, many women find it painful.
False labour pain: irregular, not progressively
increasing and not associated with bulging of forebag of water or
dilatation of the cervix.
Incidental Abdominal Pain
- Acute salpingitis: It is rarely seen because the presence
of a pregnancy in the uterus prevents ascending infection and if the
disease is chronic infertility is more likely.
- Complicated ovarian cyst: as torsion, rupture, or
Hurt burn and hiatus hernia.
Acute intestinal obstruction.
Inflammatory bowel disease: as Crohn’s disease and
- Renal calculi.
- Acute retention of urine.
- Vascular accidents: e.g.
- rectus sheath haematoma,
- mesenteric thrombosis, and
- rupture spleen or splenic aneurysm.
- Malignant lesions.
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Edited by Aldo Campana,