ABSTRACT
Abdominal pain in pregnancy is a very common symptom. In the majority of women the exact cause cannot be found, though it is thought to be physiological from musculoskeletal adaptations to an enlarging gravid uterus. Urinary tract infection is more common during pregnancy owing to incomplete emptying of the bladder from head engagement, relaxation of the ureters from progesterone and back pressure on the pelvicalyceal system of the kidney from the enlarging uterus. Torsion of the vascular pedicle leads to acute severe ischaemia, and the patient will present with acute abdominal pain, nausea, and vomiting. Presentation is usually in the second trimester of pregnancy or in the puerperium, when there is space in the pelvis to undergo torsion. Clinical examination may reveal a patient who lies in bed and may have tenderness in the lower abdomen. Uterine fibroids are regularly diagnosed at the first-trimester booking ultrasound scan. In most pregnancies the fibroids remain the same size.
