Abdominal Pain in Pregnancy Max Brinsmead MB BS PhD May 2015.

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Presentation transcript:

Abdominal Pain in 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?

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