*Abdominal pain in pregnancy

-Common complain -specific causes of bleeding in pregnancy

-*uterine fibroid degeneration

• -Myoma • -acute abdominal pain • -nausea& vomiting – mild

pyrexia • -occur between 20-22 weeks gestation • -diagnosis: by u/s • RX: bed rest –analgesia

•-sever uterine torsion: •-uterus rotate more than 90

•-abdominal pain •-predisposing factors:

•-fibroid –congenital malformation of the uterus •-adenxial mass –pelvic fracture –pelvic surgery

•Rx:-bed rest •-change maternal position to correct torsion

•-administer analgesia •-rare cases .laparatomy

•c.s delivery

*pelvic girdle pain

• -suprapubic dysfunction (SPD)• -abnormal relaxation of the ligament supporting the pubic pain • -causes :• 1-high level of pregnancy hormone especially relaxin • 2-biomechanical factors • 3-Genetic factors • Incidence 1\300• Out come of this problem :• 1-increase mobility of the joint • 2-pubic bone move up & down when woman walk • 3-strain sacroiliac joint • c\p:• -grand multigravida • -pain in the pubic region • -backache • -occur 28 weeks or in postnatal • -abdominal pain ( muscular action )• -tenderness over the symphysis pubis

Management:

• -explanation to decrease anxiety • -bed rest on firm mattress • -avoid straddle movement • -decrease non essential wt bearing activities • -avoid abduct the hip • -avoid squatting position • -use supportive panty girdle (tubgrip )• -use comfortable shoes • -increase risk for venous thrombosis

• -physio- therapies • -postnatal ligament gradually return

to its normal position so arrangement for physiotherapy is important to strength & stabilize joint .