Harbor Macros: Abdominal Pain(Female)
Non-Pregnant
yo non-pregnant woman presenting with abdominal pain. Given patient’s pregnancy test is negative, highly doubt ectopic pregnancy. Considered causes of female-specific abdominal pain unrelated to pregnancy (e.g., pelvic inflammatory disease with or without tubo-ovarian abscess, Fitz-Hugh-Curtis, etc.). Also considered causes of abdominal pain that are not gender-specific (e.g., appendicitis, volvulus, small bowel obstruction, mesenteric adenitis, acute cholecystitis/choledocholithiasis and other biliary pathology, etc.). Patient well-appearing with normal vital signs. Laboratory testing and imaging here reviewed and normal. Patient given strict return precautions for worsening pain, inability to eat/drink, fevers (temperature over 100.4F), or other concerns. Patient instructed to follow up with their primary doctor and is agreeable; all questions were answered.
Pregnant
yo G***P*** woman at *** weeks gestational age by LMP/ultrasound presenting with abdominal pain/vaginal bleeding. Considered ectopic pregnancy, spectrum of miscarriage/abortion (threatened, inevitable, incomplete, complete, septic) as well as causes of female-specific abdominal pain unrelated to pregnancy (e.g., pelvic inflammatory disease with or without tubo-ovarian abscess, Fitz-Hugh-Curtis, etc.). Also considered causes of abdominal pain that are not gender-specific (e.g., appendicitis, volvulus, small bowel obstruction, mesenteric adenitis, acute cholecystitis/choledocholithiasis and other biliary pathology, etc.). Patient well-appearing with normal vital signs. Patient is Rh *** and therefore requires/does not require RhoGAM. Gave patient strict return precautions for worsening pain, increased vaginal bleeding, fever (temperature above 100.4F), lightheadedness/syncope or other concerns.
For consideration of ectopic pregnancy, the quantitative beta hCG was *** and therefore was above/below the discriminatory zone of 1,500 mIU/mL. Transvaginal/transabdominal ultrasound demonstrated ***. Patient will follow up in 48 hours with their obstetrician.
