Chapter 22 - Ultrasonographic evaluation of acute pelvic pain

Summary

Acute pelvic pain is a common reason for women to seek urgent gynecologic evaluation. Although the classic clinical presentation is dysmenorrhea with premenstrual intensification, dyspareunia, and chronic pelvic pain, some patients, who may or may not know they have the condition, experience acute pelvic pain. Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic complication of superovulation induction therapy with a varied spectrum of clinical and laboratory manifestations. Crampy pelvic pain due to hormonal changes, rapid growth of the uterus, and increased blood flow is a common sign of early pregnancy. If a patient fails a single course of methotrexate or has pelvic pain that is increasing, ultrasound can be helpful. If a patient continues to have pain after a presumed miscarriage, even if products of conception were confirmed cytologically, a heterotopic pregnancy should be a considered.