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Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

From Jan 1, 1971 to Dec 12, 1990, 65 cases of abruptio placenta were admitted to our hospital. The incidence was 0.19%. Among them, thirty were complicated by pregnancy induced hypertension (46.2%). The perinatal fetal mortality was 19.7%; perinatal death occurred mostly in the premature group. All babies survived except two abnormalities. Cesarean section rate was 32.3%. All postpartum hemorrhage 29.2%. Couvelaire uterus 6.2%, were cured by conservative treatment. There was neither stillbirth nor newborn death in the thirty three cases treated expectant, but a newborn asphyxia rate of 6.1% and a cesarean section rate of 15.1%. Analysis showed that abruptio placentae should be suspected in cases with abnormal fetal heart rate of unknown cause accompanying signs of labor, premature labor of unknown cause, uterine tongue, ultrasonically visualized liquid from dark area behind the placenta, besides classical signs of abdominal pain and vaginal bleeding. Expectant treatment is appropriate if gestational age is small and no acute symptoms exists so as to minimize the perinatal mortality and cesarean section rate.
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PMID:[Analysis of 65 cases of abruptio placenta]. 139 97

A primigravid woman at 35 weeks' gestation was admitted with abdominal pain, fever, and vomiting. Forceful contractions and signs of fetal distress suggested abruptio placentae. During caesarean section, seropurulent exudate and a perforated appendix were found; an appendectomy was performed. A mechanism linking appendicitis with abruptio placentae is suggested.
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PMID:Abruptio placentae associated with perforated appendicitis and generalized peritonitis. 173 85

A researcher reviewed the January 1984-December 1986 birth and obstetrical records at the University of Nigeria Teaching Hospital in Enugu. During this period, the incidence rate for abruptio placentae was .44% (81/18,215). 56 of these cases were considered mild and 25 were severe. 15/81 cases did not have adequate antenatal care. 49.4% of the cases were in the 26-30 year old age group. The higher the parity of the women the higher the percentage of those with abruptio placentae, e.g., 3.7% for primigravidas and 33.3% for parity or = 5. The leading symptoms included tender uterus (87.7%), abdominal pain (85.2%), and vaginal bleeding (54.3%). Other symptoms included hypertension, shock, and proteinuria. Vaginal delivery accounted for 80.3% of the abruptio placentae births, while cesarean section accounted for 12.4%, vacuum extraction 3.7%, and breech delivery 3.7%. 91.4% of the patients required a blood transfusion with an average of 3 pints of blood/patient. 22.2% of the patients experienced severe postpartum hemorrhage as a result of uterine atony, coagulation failure, or puerperal sepsis. The perinatal mortality rate stood at 58%. None of the 15% of mothers who had severe abruptio placentae had a live infant. 16% of the infants were premature. Since most of the referred patients either did not have any antenatal care or had inadequate antenatal care, it appears that an appropriate measure to reduce the gravity of abruptio placentae would be a wider distribution of excellent antenatal and obstetric management in the rural areas.
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PMID:Abruptio placentae at the University of Nigeria Teaching Hospital, Enugu: a 3-year study. 280 22

Abruptio placentae occurred in 16 of 132 patients with severe pre-eclampsia who were admitted to an obstetric high-risk ward before 34 weeks' gestation. These 16 patients were compared with those who did not develop abruptio placentae. Systolic and diastolic blood pressure levels, proteinuria and birth weights did not differ significantly between the two groups. Apgar scores were significantly lower in the abruptio placentae group. There were 6 intra-uterine and 2 neonatal deaths in the abruptio placentae group (50% perinatal mortality (PNM] and 3 intra-uterine and 16 neonatal deaths in the other group (18% PNM). Four patients with abruptio placentae presented with abnormal fetal heart-rate patterns and 8 with abdominal pain. No warning signs were present in 3 patients and the fetal heart-rate pattern before delivery was not available in 1 patient. Abnormal fetal heart-rate patterns were present in 5 of the 8 patients who presented with pain. Abruptio placentae occurring in patients with severe proteinuric hypertension carries a high PNM. Frequent monitoring of the fetal heart rate sometimes helps to diagnose fetal distress before the clinical signs of abruption become apparent.
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PMID:Frequent fetal heart-rate monitoring for early detection of abruptio placentae in severe proteinuric hypertension. 338 52

The recent published journal reports concerning the influence of uterine myomas on pregnancy are reviewed. The prevalence of uterine myomas in pregnancy is 0.1-5%, and less than half of the cases can be diagnosed by clinical investigation alone. The previous belief that continuous growth of myomas occurs during pregnancy seems incorrect. Most myomas grow during the first trimester, whereafter only few continue to enlarge. The most often recognized complication during pregnancies with uterine myomas is abdominal pain. About ten percent will suffer from this. Treatment is with non-steroidal anti-inflammatory drugs, which are extremely effective. In resistant cases epidural blockade may be used. Placental abruption is possibly more common among women with myomas that have direct contact to the placenta, and there is a trend towards shorter pregnancies in women with myomas. Further investigation on these subjects is required. No other complications are consistently reported more frequently among women with myomas than among those without. Myomectomy during pregnancy should only be performed in extreme cases. The value of myomectomy before conception to avoid pregnancy complications is doubtful, if no other pathology is present.
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PMID:[Effect of uterine fibromas on pregnancy]. 783 29

Abdominal pain in pregnancy is most commonly caused by complications of the pregnancy, e.g., abortion, ectopic pregnancy and abruptio placentae. A careful history and methodical physical examination and, if necessary, simple ultrasonographic investigations will reveal the cause in most of these conditions. In a few cases of abdominal pain in pregnancy a gynaecological condition, such as torsion of an ovarian cyst, or a nongynaecological (medical or surgical) one is the cause. Some of these conditions are serious, e.g., acute appendicitis, and unless the correct diagnosis is made and the appropriate management promptly instituted both the mother and her baby may suffer tragic consequences. Moreover, these conditions are more likely to be misdiagnosed during pregnancy. This is because the anatomical and physiological changes which occur in pregnancy tend to change and obtund the expected clinical features and laboratory data which are used to diagnose these conditions. Their early diagnosis therefore requires a high index of suspicion together with awareness of the ways in which they may present in pregnancy.
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PMID:Abdominal pain in pregnancy. 794 66

Splenic artery aneurysm rupture during pregnancy is a rare but serious condition. The clinical presentation associates abdominal pain, hypotension and anemia that can mimic uterine rupture or abruptio placentae. An emergency cesarean section and splenectomy are necessary.
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PMID:[Rupture of a splenic artery aneurysm during pregnancy. Report of a case]. 1041 45

Placental abruption (PA) is a common cause of fetal demise in pregnant trauma patients. Diagnosis of PA may be difficult, and multiple diagnostic clues are currently used including uterine/abdominal pain and tenderness, bleeding, maternal hemodynamic instability, and evidence of PA by ultrasonography or other fetal monitoring. Although diagnosis may be problematic fetal and maternal survival are dependent on early diagnosis and intervention. The purpose of this study is to determine predictive factors present at admission associated with PA in trauma victims. Records of all pregnant trauma patients admitted to Wake Forest University Baptist Medical Center over a 5-year period were reviewed for injury characteristics and outcome. Inclusion criteria included a confirmed pregnancy and fetal disposition. Specific admission parameters evaluated included temperature, heart rate, systolic blood pressure, partial pressure of CO2 in arterial blood, total white blood cell count (WBC) and differential, hematocrit, base deficit, and lactic acid. PA is defined as a spontaneous abortion in the first trimester or abruptio placenta in the second or third trimester. Between April 1, 1996 and October 30, 2000, 30 patients met study criteria. Six of 30 patients were found to have PA (20%). Of the studied parameters WBC was significantly elevated in PA patients (27 +/- 4.6 vs 17 +/- 7.8 WBC x 10(3)/mm3; P = 0.005) as was band count (10 +/- 6.6% vs 4 +/- 6.1%; P = 0.03). Hematocrit was lower in the PA group (27 +/- 4.3% vs 32 +/- 5.4%; P = 0.04). Within this group of variables which differed on univariate analysis, WBC was the best discriminator between patients with and without PA (sensitivity 100%, specificity 79%, negative predictive value 100%, and positive predictive value 54%). In pregnant trauma patients WBC >20,000/mm3 on admission should raise suspicion of the possibility of PA, and close monitoring is warranted. Conversely WBC <20,000/mm3 rules out PA in the pregnant trauma patient (negative predictive value of 100%).
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PMID:Elevated admission white blood cell count in pregnant trauma patients: an indicator of ongoing placental abruption. 1213 51

A case of spontaneous rectus sheath hematoma is reported in a 32-year-old multigravida transferred to our antepartum unit for premature labor and persistent cough related to Candida dubliniensis upper airway infection. In pregnant patients presenting sudden-onset severe abdominal pain and parietal tenderness, there are two main differential diagnoses: abruptio placentae and aseptic necrobiosis of a uterine leiomyoma. The correct diagnosis may be obtained by ultrasonography and sometimes by computed tomography. In the present case an emergency cesarean section was performed at 35 weeks gestation after a 40% decrease in maternal hemoglobin and onset of fetal heart rate anomalies.
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PMID:[Spontaneous hematoma of the rectus sheath during pregnancy: a case report]. 1259

A 36-year-old woman, who had given birth once before, had an eclamptic epileptic seizure eight days after caesarean delivery of healthy premature twins. Severe headache and loss of vision, leading to blindness, had not been recognised as prodromal signs by the healthcare professionals involved. Thereafter, she suffered a generalised epileptic seizure with tongue bite. She recovered fully after treatment with magnesium sulphate and nifedipine. Eclampsia is a severe condition with high rates of maternal complications, such as abruptio placentae, disseminated intravascular coagulation, neurological problems, pulmonary oedema, acute renal insufficiency and even death. Recognition of prodromal symptoms like headache, visual disturbances and upper abdominal pain is of the utmost importance. Magnesium sulphate intravenously is the treatment of choice. About 25% of the cases of postpartum eclampsia develop 2-28 days after delivery. A history of pre-eclampsia before or during the delivery is often absent. There is a relative increase in the incidence of late postpartum eclampsia, possibly because of misinterpretation ofprodromal symptoms, as illustrated by this case report. Every physician should be able to recognise the symptoms of pre-eclampsia and be aware of the possible consequences.
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PMID:[Late postpartum eclampsia]. 1750 Mar 49


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