Dr. Usha Vishwanath MD, DGO

Evaluation of abdominal pain in a woman requires a methodical approach apart from meticulous history taking.

The major causes of abdominal pain can be classified according to the age of the woman:
Young adolescent girl
Women of child bearing age
Post menopausal age group

This classification is useful in focusing on the common causes of abdominal pain in these age groups.

Common aspects of history

What is the clinical presentation?
Is the Pain localized or generalized?
Is it associated with menses or ovulation?
Is there any vaginal bleeding?
Is there Fever?
Are there associated G.I. symptoms e.g. nausea, vomiting etc?
Are there associated urinary symptoms such as frequency, urgency and dysuria?
What are the patients’ vital signs?

If patient shows features of shock like tachycardia, hypotension
RULE OUT ruptured ectopic pregnancy.
If associated with menses, it is probably spasmodic dysmenorrhoea.
If abdominal distention with guarding and rigidity are present
peritonitis

secondary to septic abortion must be considered.
Exclude urinary tract infection, renal calculus, surgical causes e.g. appendicitis.
Start an intravenous line if the patient is severely ill or the vital signs are unstable.
Keep the patient NPO (nothing by mouth) if surgery is anticipated.