Surgical causes of acute abdominal pain in pregnancy

Abstract

Key content Abdominal pain in pregnancy is common, with a differential diagnosis that can encompass obstetric, surgical and medical conditions. Presentation of common surgical problems can be atypical in pregnancy, potentially delaying diagnosis. Surgical causes of abdominal pain to consider in pregnancy include appendicitis, cholecystitis, bowel obstruction, ureteric obstruction, pancreatitis and aneurysm rupture, most commonly involving the splenic artery. The management of surgical conditions in pregnancy requires continuing evaluation and potential modification to balance the medical, surgical and obstetric challenges. Management of the pregnant woman with a surgical cause of abdominal pain requires collaborative, multispecialty practice to optimise care of the mother and baby. Learning objectives To highlight the differential diagnoses of abdominal pain in pregnancy. To develop a structured assessment process for pregnant women with abdominal pain. To update the obstetrician on the priorities of surgical management for abdominal pain in pregnancy. Ethical issues Evaluating the risks of surgical interventions on the mother and baby with the high potential for premature delivery.