Family Medicine Expert Witness Discusses Pregnant Patient’s Work-Up

Occasional abdominal discomfort is a common pregnancy complaint, but it can also be a sign of a serious problem. Severe or persistent abdominal pain during pregnancy is never normal. The point when one experiences abdominal pain or cramping along with spotting, bleeding, fever, chills, vaginal discharge, or faintness is when the doctor must be visited. Symptoms such as discomfort while urinating, nausea, and vomiting, or the pain not subsiding after several minutes of rest, also require a doctor’s exam. Severe cases of abdominal pain can be due to ectopic pregnancy, miscarriage, preterm labor, placental abruption, and preeclampsia. Immediate antenatal testing such as transvaginal sonography, biophysical profile, and nonstress test should be carried out. Additional laboratory and imaging studies may also be needed to check fetal viability. Given the patient’s symptoms, it is in line with the standard of care to pursue fetal testing such as a biophysical profile and nonstress test. Moreover, the etiology of the patient’s abdominal pain was not likely due to polyps, as they tend to be an incidental finding on sonogram and are often asymptomatic. A more comprehensive workup should have been performed.