Nontraumatic abdominal surgical emergencies in the pregnant patient

One of the greatest challenges that confronts the emergency physician (EP) is care of the pregnant patient. Regardless of the gestational age of the fetus, the EP must be cognizant of the fact that he or she is now caring for two patients: the fetus and the mother. In addition, physiological changes that occur in pregnancy can affect individual complaints, presentations, and treatments. Abdominal surgical emergencies in the pregnant woman are often particularly difficult to diagnose, and management of conditions that are straightforward in the nonpregnant state can become complicated. After a brief review of the physiologic changes that impact the identification and management of abdominal emergencies in pregnancy, several specific conditions are discussed. This review also discusses the choice of imaging modalities in the evaluation of the pregnant patient with abdominal pain, in general and in the context of specific diagnoses.