Abdominal pain a pregnant lady case study

General
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1

A pregnant lady of her 18 weeks developed a sharp lower abdominal pain last night she unable to eat the food or drink the water and vomiting occurs continuously currently which test should she had to do for a proper diagnostics ?

2

I think she should urgently get an ultrasound to check the baby and uterus. Blood tests and urine analysis are also important to rule out infections, dehydration, or complications like appendicitis or miscarriage.

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3

Potential Causes:

  1. Appendicitis: A common cause of abdominal pain in pregnancy, appendicitis requires prompt surgical attention.
  2. Preterm labor: Abdominal pain can be a sign of preterm labor, especially if accompanied by contractions or cervical changes.
  3. Placental abruption: A serious condition where the placenta separates from the uterus, causing pain and potentially life-threatening bleeding.

Evaluation and Management:

  1. History and physical examination: A thorough evaluation of the patient’s symptoms, medical history, and physical examination findings.
  2. Imaging studies: Ultrasound or other imaging modalities may be used to evaluate the fetus, placenta, and maternal organs.
  3. Laboratory tests: Blood work and urinalysis can help identify potential causes, such as infection or inflammation.
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  • Ultrasound → Check fetal viability, placental location, amniotic fluid levels, fetal complications.
  • Blood tests → CBC, Beta-hCG, Liver Function Tests, Renal Function Tests
  • Urine tests → Urinalysis, Urine culture, Dip stick
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5

The essential investigations include:

  • obstetric ultrasound to rule out threatened miscarriage, placenta previa or uterine abnormalities
  • urine routine and microscopy to rule out UTI
  • CBC to check for infection, anemia or leukocytosis
  • LFT, RFT to check for electrolyte imbalance
  • abdominal ultrasound to check for appendicitis, gallstones
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6

Given the symptoms of sharp lower abdominal pain, vomiting, and inability to eat or drink at 18 weeks of pregnancy, the following tests may be considered for proper diagnosis:

  1. Ultrasound: To evaluate fetal well-being, check for any fetal distress, and assess the placenta and uterus for potential issues like placental abruption or uterine anomalies.
  2. Blood tests:
    • Complete Blood Count (CBC) to check for infection or inflammation.
    • Blood chemistry tests to evaluate liver and kidney function.
    • Beta-hCG levels may be checked, but this is more relevant in early pregnancy.
  3. Urine analysis: To check for urinary tract infections, kidney stones, or other renal issues that could be causing the symptoms.
  4. Pelvic examination: A gentle pelvic exam may be performed to assess for any cervical dilatation, uterine tenderness, or adnexal masses.

These tests can help diagnose potential causes such as:

  • Appendicitis
  • Urinary tract infection
  • Kidney stones
  • Preterm labor or cervical dilatation
  • Placental abruption
  • Other obstetric or gastrointestinal issues

Immediate medical attention is crucial to ensure the health and well-being of both the mother and the fetus.

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