tailieunhanh - Lower abdominal pain in the first trimester of pregnancy

This chapter explains briefly the conditions associated with lower abdominal pain in the first trimester of pregnancy. More details of some of the conditions are found in specific chapters. The diagnosis and management of medical and surgical causes of lower abdominal pain in pregnancy is beyond the scope of this chapter. | 3 Lower Abdominal Pain in the First Trimester of Pregnancy Sisty J. Moshi INTRODUCTION Abdominal pain in pregnancy is very common. Many of the complications of early pregnancy present with some form of abdominal pain. There are several causes of abdominal pain during early pregnancy some being directly related to pregnancy while others are unrelated medical or surgical conditions. Table 1 gives an overview of possible differential diagnoses of lower abdominal pain in early pregnancy. Specific pregnancy-related complications are commonly limited to a certain gestational age. This chapter explains briefly the conditions associated with lower abdominal pain in the first trimester of pregnancy. More details of some of the conditions are found in specific chapters. The diagnosis and management of medical and surgical causes of lower abdominal pain in pregnancy is beyond the scope of this chapter. Most gynecological causes are described in the respective chapters as indicated in Table 1. In this chapter a description of signs and symptoms will be provided for the most common differential diagnoses useful diagnostics and further management for those conditions which are not described in other chapters. Many patients presenting with lower abdominal pain in clinics are not aware of their pregnancy or do not want to reveal their condition for various cultural or personal reasons. Thus it is important to consider pregnancy in any of your patients with lower abdominal pain who are of reproductive age 15-45 years . Some of the conditions mentioned in Table 1 are life-threatening such as ectopic pregnancy. In order to make this diagnosis you must keep in mind that a pregnancy might exist even if the patient is not aware of it. Table 1 Differential diagnosis of lower abdominal pain in pregnancy Pregnancy-related Miscarriage Chapters 2 and 13 ectopic pregnancy Chapter 12 uterine rupture rare pain associated with uterine growth Non-pregnancy related Gynecological Ovarian cyst .