Abstract
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.
Keywords
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Further reading
- Non-obstetric surgery during pregnancy: a comprehensive guide.1st ed. 2019 (edition (October 30, 2018))
- Surgical causes of acute abdominal pain in pregnancy.The Obstetrician & Gynaecologist. 2019; 21: 27-35
- Management of acute abdomen in pregnancy: current perspectives.Int J Womens Health. 2019; 11 (Published 2019 Feb 8): 119-134https://doi.org/10.2147/IJWH.S151501
- Guidelines for diagnostic imaging during pregnancy and lactation. Committee opinion No. 723. American college of obstetricians and gynecologists.Obstet Gynecol. 2017; 130: e210-e216
- Guidelines for the use of laparoscopy during pregnancy.2017
Article info
Publication history
Published online: October 24, 2019
Identification
Copyright
© 2019 Elsevier Ltd. All rights reserved.
