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Abdominal Pain in Pregnancy

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1. Assessment of abdominal pain in pregnancy

Assessment of abdominal pain in pregnancy Assessment of abdominal pain in pregnancy - Differential diagnosis of symptoms | BMJ Best Practice You'll need a subscription to access all of BMJ Best Practice Search  Assessment of abdominal pain in pregnancy Last reviewed: February 2019 Last updated: June 2018 Summary Abdominal pain throughout pregnancy is common. Many adaptive or physiological changes of pregnancy affect the presentation. Women tend to visit doctors often as they are concerned (...) about the health of their fetus. Patients require a careful assessment in order to reduce anxiety and give reassurance. If the clinical picture is unclear, a specialist should be consulted. Chamberlain G. ABC of antenatal care: abdominal pain in pregnancy. BMJ. 1991;302:390-1394. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1670063/pdf/bmj00129-0073.pdf http://www.ncbi.nlm.nih.gov/pubmed/2059722?tool=bestpractice.com Augustin G, Majerovic M. Non-obstetrical acute abdomen during pregnancy. Eur J

2018 BMJ Best Practice

3. Assessment of abdominal pain in children

Assessment of abdominal pain in children Assessment of abdominal pain in children - Differential diagnosis of symptoms | BMJ Best Practice   Search  Assessment of abdominal pain in children Last reviewed: February 2019 Last updated: June 2018 Summary Paediatric abdominal pain is often a diagnostic dilemma. It is a common problem and, although the vast majority of these episodes are benign and self-limiting, persistent abdominal pain may signify an underlying pathology requiring urgent (...) intervention. Timely assessment and intervention are critical in preventing untoward sequelae in children presenting with abdominal pain. Because of the spectrum of aetiologies that manifest as abdominal pain, the differential remains broad and diagnosis can be challenging. In most cases, a thorough history and physical examination can narrow the broad differential. However, depending on the age of the child, additional investigations may be required to delineate diseases that present with similar symptoms

2018 BMJ Best Practice

4. Shingles in Pregnancy: An Elusive Case of Left Upper Quadrant Abdominal Pain (PubMed)

Shingles in Pregnancy: An Elusive Case of Left Upper Quadrant Abdominal Pain Pregnancy can complicate the presentation and workup of abdominal pain. A healthy 21-year-old gravida-3 para-1 woman at 34 weeks of gestation presented for severe pain localized to her abdominal left upper quadrant (LUQ. Physical exam was unremarkable except for localized pain on palpation, and she was discharged with acetaminophen and cyclobenzaprine for presumed musculoskeletal pain. The next day, she returned (...) followed by the eruption of vesicles. This case is important because it reviews the significance of shingles in pregnancy and is one of the first reports to extensively discuss the differential and workup of LUQ abdominal pain in pregnancy. Abdominal pain is a relatively common complaint during pregnancy, and a methodical approach should be taken when evaluating LUQ in pregnancy. Shingles could be considered in the differential diagnosis of pain of unclear origin.

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2018 Hawai'i Journal of Medicine & Public Health

5. Hydrosalpinx with acute abdominal pain during the third trimester of pregnancy: A case report (PubMed)

Hydrosalpinx with acute abdominal pain during the third trimester of pregnancy: A case report Acute abdomen in pregnancy is a unique clinical challenge. We report a rare case of hydrosalpinx presenting as acute abdomen in the third trimester of pregnancy in the absence of infection and hormonal treatment.A 38-year-old Caucasian woman (gravida 4, para 3), at an estimated 29 weeks of a spontaneous singleton pregnancy, presented to the emergency department with severe abdominal pain in the right (...) lower quadrant, which had been present for three days. Magnetic resonance imaging (MRI) demonstrated a right-sided hydrosalpinx. It was successfully treated with conservative treatment and the patient delivered vaginally at term without complication.Hydrosalpinx should be considered as one of the differential diagnoses for acute abdomen during pregnancy. A multidisciplinary approach is recommended, with a careful work-up, due to the risks to both fetus and mother.

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2018 Case Reports in Women's Health

6. Acute Nonlocalized Abdominal Pain

management in 53% of patients solely with abdominal pain, but in only 11% of patients with concomitant diarrhea, stressing a “thoughtful approach” to CT imaging in this setting [82]. In addition, a retrospective analysis of 127 patients with nonspecific upper abdominal pain showed a negative predictive value for CT to be relatively low at 64%, with more commonly missed diseases to include pancreaticobiliary inflammatory processes as well as gastritis and duodenitis [83]. In the setting of pregnancy, CT (...) may have a role, particularly if the scenario is emergent and MRI is not readily available and/or when US findings are nondiagnostic or equivocal. ACR Appropriateness Criteria ® 11 Acute Nonlocalized Abdominal Pain MRI Abdomen and Pelvis MRI has been shown to provide clinically useful information for rapid diagnosis of acute bowel pathology [35,58,84,85] and the following gynecological emergencies: ovarian hemorrhage, ectopic pregnancy, tumor rupture, torsion, hemorrhage, infarction, and pelvic

2018 American College of Radiology

7. The transverse abdominal muscle is excessively active during active straight leg raising in pregnancy-related posterior pelvic girdle pain: an observational study. (PubMed)

The transverse abdominal muscle is excessively active during active straight leg raising in pregnancy-related posterior pelvic girdle pain: an observational study. Many studies suggest that impairment of motor control is the mechanical component of the pathogenesis of painful disorders in the lumbo-sacral region; however, this theory is still unproven and the results and recommendations for intervention remain questionable. The need for a force to compress both innominate bones against (...) the sacrum is the basis for treatment of pregnancy-related pelvic girdle pain (PGP). Therefore, it is advised to use a pelvic belt and do exercises to enhance contraction of the muscles which provide this compression. However, our clinical experience is that contraction of those muscles appears to be excessive in PGP. Therefore, in patients with long-lasting pregnancy-related posterior PGP, there is a need to investigate the contraction pattern of an important muscle that provides a compressive force

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2017 BMC Musculoskeletal Disorders

8. Is the Pelvic Examination Still Crucial in Patients Presenting to the Emergency Department With Vaginal Bleeding or Abdominal Pain When an Intrauterine Pregnancy Is Identified on Ultrasonography? A Randomized Controlled Trial. (PubMed)

Is the Pelvic Examination Still Crucial in Patients Presenting to the Emergency Department With Vaginal Bleeding or Abdominal Pain When an Intrauterine Pregnancy Is Identified on Ultrasonography? A Randomized Controlled Trial. We determine whether omitting the pelvic examination in emergency department (ED) evaluation of vaginal bleeding or lower abdominal pain in ultrasonographically confirmed early intrauterine pregnancy is equivalent to performing the examination.We conducted a prospective (...) , open-label, randomized, equivalence trial in pregnant patients presenting to the ED from February 2011 to November 2015. Patients were randomized to no pelvic examination versus pelvic examination. Inclusion criteria were aged 18 years or older, English speaking, vaginal bleeding or lower abdominal pain, positive β-human chorionic gonadotropin result, and less than 16-week intrauterine pregnancy by ultrasonography. Thirty-day record review and follow-up call assessed for composite morbidity

2017 Annals of Emergency Medicine Controlled trial quality: predicted high

9. CRACKCast E027 – Abdominal Pain

pregnancy Females of childbearing age. 1/100 pregnancies Risk factors: Non-white race, older age, history of STI/PID, infertility treatment, IUD in the last year, tubal ligation, previous ectopic pregnancy, smoking, fallopian surgery Symptoms: Severe, sharp pain or may be diffuse with shock or peritonitis With or without vaginal bleeding. Physical exam features do not rule in or out the diagnosis Abdominal and vaginal symptoms may or may not be present. FAST exam, U/S, BHcG necessary Ruptured or leaking (...) CRACKCast E027 – Abdominal Pain CRACKCast E027 - Abdominal Pain - CanadiEM CRACKCast E027 – Abdominal Pain In , by Adam Thomas February 16, 2017 This episode of CRACKCast cover’s Rosen’s Chapter 27, Abdominal Pain. Abdominal pain is one of the most common presenting symptoms in the ER and a good approach is vital for ER docs. Shownotes – Rosen’s in Perspective Common and challenging presentation: History and physical examination can be misleading Serious pain can be benign and mild pain can

2017 CandiEM

10. Abdominal Pain in Pregnancy

Abdominal Pain in Pregnancy Abdominal Pain in Pregnancy Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Abdominal Pain in Pregnancy (...) Abdominal Pain in Pregnancy Aka: Abdominal Pain in Pregnancy II. Causes: Non-Pregnancy Related disease or (cystitis, ) III. Causes: Pregnancy Related or (>20 weeks gestation) Round Ligament Pain IV. References Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Abdominal Pain in Pregnancy." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Related Topics

2018 FP Notebook

11. The Impact of Upper Abdominal Pain During Pregnancy Following a Gastric Bypass. (PubMed)

The Impact of Upper Abdominal Pain During Pregnancy Following a Gastric Bypass. The aim of the present study was to describe the risk of internal herniation (IH) and the obstetric outcome in pregnant women with Roux-en-Y gastric bypass (RYGB) and episodes of upper abdominal pain.The cohort included 133 women with RYGB: 94 with 113 pregnancies, from the local area referred for routine antenatal care (local cohort) and 39 with 40 pregnancies referred from other hospitals for specialist (...) consultation due to RYGB. RYGB was mainly performed without closure of the mesenteric defects. Data collected from medical records were episodes of upper abdominal pain, pregestational and gestational abdominal surgery and pregnancy outcome. The risk of upper abdominal pain was estimated in the local cohort. Surgical intervention, IH and obstetric outcome according to pain were evaluated for 139 pregnancies with delivery of a singleton after 24 weeks of gestation (birth cohort).Upper abdominal pain

2016 Obesity Surgery

12. Correlating abdominal pain and intra-abdominal injury in patients with blunt abdominal trauma (PubMed)

Correlating abdominal pain and intra-abdominal injury in patients with blunt abdominal trauma A thorough history and physical examination in patients with blunt abdominal trauma (BAT) is important to safely exclude clinically significant intra-abdominal injury (IAI). We seek to evaluate a correlation between self-reported abdominal pain, abdominal tenderness on examination and IAI discovered on CT or during exploratory laparotomy.This retrospective analysis assessed patients with BAT ≥13 years (...) old who arrived to the emergency department following BAT during the 23-month study period. Upon arrival, the trauma team examined all patients. Only those who underwent an abdominal and pelvic CT scan were included. Patients were excluded if they were unable to communicate or lacked documentation, had obvious evidence of extra-abdominal distracting injuries, had a positive drug or alcohol screen, had a Glasgow Coma Scale ≤13, or had a positive pregnancy screening. The primary objective

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2017 Trauma Surgery & Acute Care Open

13. Ruptured secondary abdominal pregnancy after primary laparoscopic treatment for tubal pregnancy: A case report. (PubMed)

in abdomen or pelvis. Beta human chorionic gonadotropin levels dropped significantly after surgery, but the patient came back again for severe abdominal pain with beta human chorionic gonadotropin increasing, and free peritoneal fluid in the pouch of Douglas was detected at ultrasonography. The secondary laparoscopy was done according to the intraperitoneal hemorrhage and unstable vital signs. The secondary pregnancy was found ruptured in the splenic flexure of the colon. Although several cases (...) Ruptured secondary abdominal pregnancy after primary laparoscopic treatment for tubal pregnancy: A case report. Most secondary abdominal pregnancies happen after spontaneous abortion of tubal pregnancy or ruptured intrauterine pregnancy. However, we presented a case of ruptured secondary abdominal pregnancy after primary laparoscopic treatment of tubal pregnancy.The ectopic pregnant lesion in the affected tube was thoroughly removed in the primary laparoscopy, and nothing abnormal was detected

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2017 Medicine

14. Laparoscopy for the management of acute lower abdominal pain in women of childbearing age. (PubMed)

Laparoscopy for the management of acute lower abdominal pain in women of childbearing age. This is an updated version of the original review, published in Issue 1, 2011, of The Cochrane Library. Acute lower abdominal pain is common, and making a diagnosis is particularly challenging in premenopausal women, as ovulation and menstruation symptoms overlap with symptoms of appendicitis, early pregnancy complications and pelvic infection. A management strategy involving early laparoscopy could (...) potentially provide a more accurate diagnosis, earlier treatment and reduced risk of complications.To evaluate the effectiveness and harms of laparoscopy for the management of acute lower abdominal pain in women of childbearing age.The Menstrual Disorders and Subfertility Group (MDSG) Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, EMBASE, PsycINFO, LILACS and CINAHL were searched (October 2013). The International Clinical Trials Registry

2014 Cochrane

15. Abdominal decompression in normal pregnancy. (PubMed)

Abdominal decompression in normal pregnancy. Abdominal decompression was developed as a means of pain relief during labour. It has also been used for complications of pregnancy, and in healthy pregnant women in an attempt to improve fetal wellbeing and intellectual development.The objective of this review was to assess the effects of prophylactic abdominal decompression on pregnancy outcomes such as admission for pre-eclampsia, fetal growth, perinatal morbidity and mortality and childhood (...) development.We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (2 February 2012).Randomised trials comparing abdominal decompression with dummy decompression or no treatment in healthy pregnant women.Both review authors assessed eligibility and trial quality.Three studies were included. There was no difference between the abdominal decompression groups and the control groups for low birthweight (risk ratio (RR) 0.69, 95% confidence interval (CI) 0.27 to 1.77) and perinatal mortality

2012 Cochrane

16. Successful Pregnancy and Delivery after Autologous Abdominal Wall Reconstruction using Anterolateral-Thigh and Iliotibial-Tract Flap (PubMed)

Successful Pregnancy and Delivery after Autologous Abdominal Wall Reconstruction using Anterolateral-Thigh and Iliotibial-Tract Flap The surgical management of abdominal wall tumor in women with childbearing potential is a thorny issue. A synthetic mesh is widely used for abdominal wall reconstruction but not necessarily applicable in case of women of childbearing potential because it has been reported to cause severe pain during pregnancy. Autologous reconstruction is usually considered (...) achieved pregnancy and a full-term delivery without complications with the exception of a feeling of mild stretching in the area of the operation. Magnetic resonance imaging and a clinical examination after the delivery revealed no signs of abdominal wall hernia or bulging. Normal pregnancy and full-term delivery could be obtained after abdominal wall resection and autologous reconstruction using an anterolateral thigh + iliotibial tract flap. This reconstructive method is considered to be a versatile

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2018 Plastic and Reconstructive Surgery Global Open

17. Successful Management of Abdominal Pregnancy: Two Case Reports (PubMed)

patient, a para 2 at 14 weeks gestation, presented with abdominal pain, distension, and dizziness, which had started four days prior. The initial radiological scan reported an intrauterine pregnancy with ascites, but a bedside ultrasound revealed an empty uterus and a viable pregnancy located in the Pouch of Douglas (POD). This was a secondary abdominal pregnancy managed successfully by laparotomy. The second patient, a para 3 + 4 miscarriages with seven weeks amenorrhea was admitted with an initial (...) Successful Management of Abdominal Pregnancy: Two Case Reports Abdominal pregnancy is a rare, life-threatening condition defined as pregnancy in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary locations. It can be primarily located in the peritoneal cavity or secondary to a ruptured ectopic pregnancy or tubal abortion. We present two cases of abdominal pregnancy, one primary and another secondary, both diagnosed and successfully managed in our institution. The first

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2018 Oman medical journal

18. Intra-abdominal Rupture of a Live Cervical Pregnancy with Placenta Accreta but Without Vaginal Bleeding (PubMed)

Intra-abdominal Rupture of a Live Cervical Pregnancy with Placenta Accreta but Without Vaginal Bleeding We describe an unusual ruptured ectopic pregnancy. The unique features of the case include abdominal pain without vaginal bleeding; cervical implantation and a placenta accreta; and the late presentation at 16 weeks of gestation without prior symptoms. Both the initial point-of-care ultrasound and the formal ultrasound were interpreted as showing an intrauterine pregnancy. The clinical (...) presentation was misleading; the correct diagnosis was made by magnetic resonance imaging. We show the ultrasonic images. We discuss cervical ectopic pregnancies, their diagnosis and management. The woman survived but required emergency hysterectomy and many units of blood.

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2018 Clinical Practice and Cases in Emergency Medicine

19. Ultrasound Assessment of Abdominal Muscle Thickness in Women With and Without Low Back Pain During Pregnancy. (PubMed)

Ultrasound Assessment of Abdominal Muscle Thickness in Women With and Without Low Back Pain During Pregnancy. The aim of this preliminary study was to determine the differences in abdominal musculature thickness, within 1 month of delivery, in women who experienced back pain during pregnancy compared with those who did not.B-mode ultrasound imaging was used to measure abdominal muscle thickness on 76 postpartum participants who participated in a larger study; 47 women experienced back pain (...) during pregnancy, and 29 did not. Participant data were stratified by group, and primary comparisons were based on these grouping across the abdominal muscles, including rectus abdominis (upper and lower fibers), external oblique, internal oblique, and transversus abdominis. Means and standard deviations were also used to set parameters for future studies.In the present study, there was no difference in any abdominal muscle thickness between groups. Women with low back pain were significantly shorter

2017 Journal of Manipulative and Physiological Therapeutics

20. Complicated abdominal pregnancy with placenta feeding off sacral plexus and subsequent multiple ectopic pregnancies during a 4-year follow-up: a case report (PubMed)

difference with regards to severity of morbidity and mortality risk. After an extensive search of the English language medical literature, we are unaware of any case of abdominal pregnancy in which the placenta was receiving its vascular supply from the sacral plexus.A 26-year-old African-American woman, primigravida, at 16 weeks 4 days' gestation, presented to our Emergency Department with abdominal pain. She did not complain of any vaginal bleeding. A physical examination revealed mild abdominal (...) Complicated abdominal pregnancy with placenta feeding off sacral plexus and subsequent multiple ectopic pregnancies during a 4-year follow-up: a case report Abdominal pregnancy (pregnancy in the peritoneal cavity) is a very rare and serious type of extrauterine gestation that accounts for approximately 1.4% of all ectopic pregnancies. It also represents one of the few times an ectopic pregnancy can be carried to term. Early strategic diagnosis and management decisions can make a critical

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2016 Journal of medical case reports

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