Pregnancy (main)

Background
  • Maternal Vitals and Labs in Pregnancy

Clinical Features
  • Fundal Exam in Pregnancy

Differential Diagnosis

Abdominal distention

Vaginal Bleeding in Pregnancy (<20wks)
  • Ectopic pregnancy
  • Subchorionic hematoma
  • First Trimester Abortion
    • Complete Abortion
    • Incomplete Abortion
    • Inevitable Abortion
    • Missed Abortion
    • Septic abortion
    • Threatened Abortion
  • Gestational trophoblastic disease
    • Consider when pregnancy-induced hypertension is seen before 24 wks of gestation
  • Heterotopic pregnancy
  • Implantation bleeding
  • Molar pregnancy
  • Non-pregnancy related bleeding

Abdominal Pain in Pregnancy

The same abdominal pain differential as non-pregnant patients, plus:

<20 Weeks

>20 Weeks

Any time

3rd Trimester/Postpartum Emergencies

Evaluation

Repeat B-hCG Levels
Pregnancy Type B-hCG Change
Normal
  • Increase >53% in 48hrs (until 10,000 mIU/ml)
  • Depends on the initial value:
    • <1500 --> 50% increase
    • 1500-3000 --> 40% increase
    • > 3000 --> 30% increase
Ectopic
  • Increases or decreases slowly ("plateau")^
Miscarriage
  • Decreases >20% in 48 hrs

^Initial level CANNOT be used to rule-out ectopic

Management
  • Drug Ratings in Pregnancy

See Also
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