Abdominal pain in late pregnancy

Published:October 24, 2019DOI:


      Abdominal pain in late pregnancy is a common presentation and can pose a diagnostic and management dilemma to clinicians. An acute abdomen affects 1 in 500 pregnancies with approximately 0.5%–2% of pregnant women needing surgical interventions in pregnancy. The majority of acute abdominal complaints will present in a similar manner to the non-pregnant patient, however the anatomical and physiological changes of pregnancy can complicate the diagnosis and management options. Appendicitis remains the most common cause of an acute abdomen in pregnancy. Management should be tailored depending on the patient and the severity of the condition. Special consideration should be made for the fetus but the life of the mother should be of primary concern. Surgery can therefore be performed at any stage of pregnancy if, on balance, it is the most appropriate option. Clinicians should not neglect obstetric causes of pain and endeavour to always diagnose the underlying cause of the abdominal pain to aid management. This article explores the different aetiologies of pain in late pregnancy and latest advances in management.


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      Further reading

        • Kavic Michael S.
        • Lanzafame Raymond J.
        • Lindsay Michael K.
        • Polk Travis M.
        Non-obstetric surgery during pregnancy: a comprehensive guide.
        1st ed. 2019 (edition (October 30, 2018))
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        Surgical causes of acute abdominal pain in pregnancy.
        The Obstetrician & Gynaecologist. 2019; 21: 27-35
        • Zachariah S.K.
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        Management of acute abdomen in pregnancy: current perspectives.
        Int J Womens Health. 2019; 11 (Published 2019 Feb 8): 119-134
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        Obstet Gynecol. 2017; 130: e210-e216
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        • et al.
        Guidelines for the use of laparoscopy during pregnancy.