A 32-year-old woman now at 32 weeks' gestation is complaining of right-sided sharp abdominal pain. The patient is examined by the clinic nurse and given information about abdominal discomfort in pregnancy
She is also instructed to seek immediate attention if she (select all that apply):
a. Has heartburn
b. Has chills or a fever
c. Feels decreased fetal movements
d. Has increased abdominal pain
ANS: b, c, d
Heartburn is a common discomfort throughout pregnancy. Because the appendix is pushed upward and posterior by the gravid uterus, the typical location of pain is not a reliable indicator for a ruptured appendix during pregnancy. The pain should gradually subside, but if it persists or is accompanied by fever, a change in bowel habits, or decreased fetal movement, the patient should promptly contact her medical provider.
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