II. Causes: Non-Pregnancy Related
III. Causes: Pregnancy Related
- Preeclampsia or HELLP Syndrome (>20 weeks gestation)
- Acute Fatty Liver of Pregnancy
- Ectopic Pregnancy
- Placental Abruption
- Spontaneous Abortion
- Intrauterine Fetal Demise
- Round Ligament Pain
- Preterm Labor
- Blunt Trauma in Pregnancy
IV. Imaging: RLQ Abdominal Pain in Pregnancy (Appendicitis Evaluation)
-
Abdomen MRI without contrast
- Non-contrast MRI is as accurate as with gadolinium contrast
- Test Sensitivity: 94% (range 87 to 98%, best efficacy with MR-expert radiologists)
- Test Specificity: 97% (range 96 to 98%)
- Duke (2016) AJR Am J Roentgenol 206(3): 508-17 [PubMed]
-
Ultrasound RLQ
- Test Sensitivity may be as low as 18%
- Test Specificity 99%
-
Abdomen and Pelvis CT
- MRI and Ultrasound are preferred instead due to lack of ionizing radiation
- ACR rates CT in pregnancy as "may be appropriate"
- Low osmolality iodinated contrast is not associated with known mutagenesis or Teratogenesis
- Single Abdomen and Pelvis CT ionizing radiation dose is below exposure known to cause Teratogenesis
- References
- Broder (2022) Crit Dec Emerg Med 36(7): 20-1
