Abdominal Pain in a 26-Yr-Old Pregnant Woman

Physical Examination

  • General appearance: Well-developed female, appears tired and ill but in no apparent distress.

  • Vital signs:
  • Temperature: 38.8° C
  • Pulse: 120 beats/minute
  • BP: 110/76 mm Hg
  • Respirations: 20/minute

  • Skin: Hot, diaphoretic. No rash or cyanosis.

  • HEENT: Dry mucous membranes, no scleral icterus or conjunctival injection, neck is supple, no adenopathy.

  • Pulmonary: Breath sounds are equal bilaterally with good air movement in all fields. There are faint inspiratory crackles present on the left side heard more at the base. No wheezing.

  • Cardiovascular: Mild tachycardia with regular rhythm; no murmurs, rubs, or gallop. No peripheral edema.

  • Gastrointestinal: Bowel sounds normal. Abdomen soft, diffusely tender across the lower abdomen bilaterally with no guarding, rigidity, or rebound. No tenderness in the upper quadrants, gravid, non-tender uterus 2 cm below the level of the umbilicus. No inguinal or femoral hernias. Rectal examination non-tender, stool brown, heme negative.

  • Genitourinary: Normal external genitalia, no cervical motion tenderness, scant thin white discharge from the cervical os, which appears closed. Fetal heartbeat regular at 150 beats/minute.

  • Musculoskeletal: No swelling, tenderness or deformity of joints or extremities. Positive costovertebral angle tenderness bilaterally.

  • Neurologic: Unremarkable

  • Mental status: Alert and oriented, with fluent and coherent speech.