Book contents
- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Section 1 Basic Sciences in Obstetrics
- Section 2 Early Pregnancy Problems
- Chapter 6 Bleeding in Early Pregnancy
- Chapter 7 Acute Abdomen in Early Pregnancy
- Chapter 8 Gestational Trophoblastic Disease
- Chapter 9 Hyperemesis Gravidarum
- Section 3 Fetal Medicine
- Section 4 Maternal Medicine
- Section 5 Intrapartum Care
- Section 6 Neonatal Problems
- Section 7 Placenta
- Section 8 Public Health Issues in Obstetrics
- Section 9 Co-Morbidities during Pregnancy
- Index
- Plate Section (PDF Only)
- References
Chapter 7 - Acute Abdomen in Early Pregnancy
from Section 2 - Early Pregnancy Problems
Published online by Cambridge University Press: 20 November 2021
Book contents
- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
- The EBCOG Postgraduate Textbook of Obstetrics & Gynaecology
- Copyright page
- Dedication
- Contents
- Contributors
- Preface
- Section 1 Basic Sciences in Obstetrics
- Section 2 Early Pregnancy Problems
- Chapter 6 Bleeding in Early Pregnancy
- Chapter 7 Acute Abdomen in Early Pregnancy
- Chapter 8 Gestational Trophoblastic Disease
- Chapter 9 Hyperemesis Gravidarum
- Section 3 Fetal Medicine
- Section 4 Maternal Medicine
- Section 5 Intrapartum Care
- Section 6 Neonatal Problems
- Section 7 Placenta
- Section 8 Public Health Issues in Obstetrics
- Section 9 Co-Morbidities during Pregnancy
- Index
- Plate Section (PDF Only)
- References
Summary
Acute abdomen describes severe abdominal pain usually of less than 24 hours’ duration that may require emergency surgery. This is a very common presentation in the gynaecology services. In the pregnant patient the underlying cause may be pregnancy related or non-pregnancy related. Assessment and diagnosis are often challenging due to the influence of pregnancy on maternal physiology and the very wide range of differential diagnoses [1]. Abdominal pain is a very common symptom in pregnancy that most often resolves without much intervention. This observation may make the clinician complacent and therefore less suspicious of more serious or life-threatening underlying pathology. Diagnostic evaluation is further complicated by altered reference ranges of laboratory tests. A multidisciplinary team approach is essential to facilitate an efficient diagnostic workup as well as ensuring the most effective treatment is initiated without undue delay.
- Type
- Chapter
- Information
- The EBCOG Postgraduate Textbook of Obstetrics & GynaecologyObstetrics & Maternal-Fetal Medicine, pp. 55 - 63Publisher: Cambridge University PressPrint publication year: 2021
References
Chandraharan, E, Arulkumaran, S. Acute abdomen and abdominal pain in pregnancy. Obstet Gynaecol Reprod Med. 2008;18(8):205–12.Google Scholar
Sivanesaratnam, V. The acute abdomen and the obstetrician. Best Pract Res Clin Obstet Gynaecol. 2000;14(1):89–102.Google Scholar
CEMACH. Saving Mothers’ Lives: Reviewing Maternal Deaths to Make Motherhood Safer – 2003–2005. London: CEMACH; 2007.Google Scholar
Skubic, JJ, Salim, A. Emergency general surgery in pregnancy. Trauma Surg Acute Care Open. 2017;2(1): e000125.Google Scholar
Yeomans, ER, Gilstrap, LC. Physiologic changes in pregnancy and their impact on critical care. Crit Care Med. 2005;33:S256–8.Google Scholar
Madhra, M, Otify, M, Horne, AW. Ectopic pregnancy. Obstet Gynaecol Reprod Med. 2017;27(8):245–50.Google Scholar
Weston, P, Moroz, P. Appendicitis in pregnancy: how to manage and whether to deliver. Obstet Gynaecol. 2015;17:105–10.Google Scholar
Aggenbach, L, Zeeman, GG, Cantineau, AE, Gordijn, SJ, Hofker, HS. Impact of appendicitis during pregnancy: no delay in accurate diagnosis and treatment. Int J Surg. 2015;15:84–9.Google Scholar
Huang, C, Hong, MK, Ding, DC. A review of ovary torsion. Ci Ji Yi Xue Za Zhi. 2017;29(3):143–7.Google ScholarPubMed
Elson, CJ, Salim, R, Potdar, N, Chetty, M, Ross, JA, Kirk, EJ, on behalf of the Royal College of Obstetricians and Gynaecologists. Diagnosis and management of ectopic pregnancy. BJOG. 2016;123:e15–e55.Google Scholar
The National Institute for Health and Care Excellence (NICE). Ectopic pregnancy and miscarriage: diagnosis and initial management. Clinical guideline [CG154]. U.K.: NICE;2012. www.nice.org.uk/guidance/CG154.Google Scholar
Sagili, H, Divers, M. Modern management of miscarriage. Obstet Gynaecol. 2007;9:102–8.Google Scholar
Al‐Memar, M, Kirk, E, Bourne, T. The role of ultrasonography in the diagnosis and management of early pregnancy complications. Obstet Gynaecol. 2015;17(3):173–81.Google Scholar
Alalade, A, Maraj, H. Management of adnexal masses in pregnancy. Obstet Gynaecol. 2017;19(4):317–25.CrossRefGoogle Scholar
Damigos, E, Johns, J, Ross, J. An update on the diagnosis and management of ovarian torsion. Obstet Gynaecol. 2012;14(4):229–36.Google Scholar
Woodfield, CA, Lazarus, E, Chen, KC, Mayo-Smith, WW. Abdominal pain in pregnancy: diagnoses and imaging unique to pregnancy – review. AJR Am J Roentgenol. 2010 194(1):238–44.Google ScholarPubMed
Currie, A, Bradley, E, McEwen, M, Al-Shabibi, N, Willson, PD. Laparoscopic approach to fibroid torsion presenting as an acute abdomen in pregnancy. JSLS. 2013;17(4):665–7.Google Scholar
Stone, K. Acute abdominal emergencies associated with pregnancy. Clin Obstet Gynecol. 2002;45:553.Google Scholar
Dhupar, R, Smaldone, GM, Hamad, GG. Is there a benefit to delaying cholecystectomy for symptomatic gallbladder disease during pregnancy? Surg Endosc. 2010;24:108–12.Google Scholar
Mali, P. Pancreatitis in pregnancy: etiology, diagnosis, treatment, and outcomes. Hepatobiliary Pancreat Dis Int. 2016;15:434–8.Google Scholar
Longo, SA, Moore, RC, Canzoneri, BJ, Robichaux, A. Gastrointestinal conditions during pregnancy. Clin Colon Rectal Surg. 2010; 23:80.Google Scholar
Perdue, PW, Johnson, HW, Stafford, PW. Intestinal obstruction complicating pregnancy. Am J Surg. 1992;164:384–8.Google Scholar
Pinas-Carrillo, A, Chandraharan, E. Abdominal pain in pregnancy: a rational approach to management. Obstet Gynaecol Reprod Med. 2017;27(4):112–19.Google Scholar
Shervington, JP, Cox, C, Abdominal pain in pregnancy: diagnosis, surgery and anaesthesia. Obstet Gynaecol. 2000;2:17–22.Google Scholar
Casciani, E, De Vincentiis, C, Mazzei, MA, et al. Errors in imaging the pregnant patient with acute abdomen. Abdom Imaging. 2015 Oct;40(7):2112–26.Google Scholar
Groen, RS, Bae, JY, Lim, KJ. Fear of the unknown: ionizing radiation exposure during pregnancy. Am J Obstet Gynecol. 2012;206:456–62.CrossRefGoogle ScholarPubMed
Jain, C. ACOG Committee Opinion No. 723: Guidelines for Diagnostic Imaging During Pregnancy and Lactation. Obstet Gynecol. 2019;133(1):186.Google Scholar
Baron, KT, Arleo, EK, Robinson, C, Sanelli, PC. Comparing the diagnostic performance of MRI versus CT in the evaluation of acute nontraumatic abdominal pain during pregnancy. Emerg Radiol. 2012;19:519–25.Google Scholar
Khandelwal, A, Fasih, N, Kielar, A. Imaging of acute abdomen in pregnancy. Radiol Clin North Am. 2013;51(6):1005–22.Google Scholar
Kilpatrick, CC, Orejuela, FJ. Management of the acute abdomen in pregnancy: a review. Curr Opin Obstet Gynecol. 2008;20(6):534–9.CrossRefGoogle ScholarPubMed
Al-Fozan, H, Tulandi, T. Safety and risks of laparoscopy in pregnancy. Curr Opin Obstet Gynecol. 2002;14:375–9.Google Scholar
Kilpatrick, CC, Monga, M. Approach to the acute abdomen in pregnancy. Obstet Gynecol Clin North Am. 2007;34:389–402.CrossRefGoogle Scholar
Taylor, D, Perry, RL. Acute abdomen and pregnancy. eMedicine. 2014. https://emedicine.medscape.com/article/195976-overview#a12.Google Scholar