BMJ 1994;308:1562-1563 (11 June)

Education and debate

Lesson of the Week: Upper abdominal pain in pregnancy may indicate pre-eclampsia

C Barry, R Fox, G Stirrat 

University Department of Obstetrics and Gynaecology, St Michael's Hospital, Bristol BS2 8EG, Correspondence to: Dr Fox.

Pre-eclampsia is one of the prime causes of maternal and perinatal morbidity and mortality. The syndrome is highly variable, and the clinical presentation is often atypical. We describe the case histories of three women who presented with epigastric pain as the first outward manifestation of the disorder and in whom the diagnosis was initially overlooked.

Case reports Case 1

A 28 year old primigravida attended her general practitioner's surgery at 34 weeks' gestation with pain in the right upper quadrant, nausea, and vomiting. An antacid was prescribed for presumed reflux oesophagitis. Her blood pressure was not measured and her urine was not tested for protein. The symptoms persisted, and five days later she presented to the hospital antenatal clinic. On examination her blood pressure was 140/80 mm Hg and urine analysis showed proteinuria (2+). She had appreciable tenderness of the right hypochondrium. Further investigation disclosed a moderate . . . [Full text of this article]


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Relevant Article

Upper abdominal pain in pregnancy Immediate admission is inappropriate
S Wookey, H N Morris, M Johnson, P Steer, and J Price
BMJ 1994 309: 270-271. [Extract] [Full Text]

This article has been cited by other articles:

  • Munro, P. T (2000). Management of eclampsia in the accident and emergency department. Emerg. Med. J. 17: 7-11 [Abstract] [Full text]  
  • Wookey, S, Morris, H N, Johnson, M, Steer, P, Price, J (1994). Upper abdominal pain in pregnancy Immediate admission is inappropriate. BMJ 309: 270a-271 [Full text]  
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