Pelvic Pain

Question 1

Define Endometriosis

Answer 1

Endometriosis is the presence and growth of tissues similar to the endometrium, outside the uterus

Question 2

Who is more common to be affected by endometriosis?

Answer 2

Nulliparous women who are aged 30-45

Question 3

Endometriosis is dependent on which hormone?

Answer 3

Oestrogen

Question 4

What happens to the signs and symptoms of endometriosis during pregnancy?

Answer 4

As endometriosis is oestrogen dependent, during pregnancy (and menopause), endometriosis regresses

Question 5

What are the complications of endometriosis?

Answer 5

Formation of accumulated altered dark brown blood, known as chocolate cysts or endometrioma.
It can also result in inflammation, fibrosis and adhesion.

Question 6

What are the possible causes of acute pelvic pain?

Answer 6

Ectopic Pregnancy
Pain during ovulation
Ovarian cyst torsion, rupture, or haemorrhagic cyst
Dysmenorrhoea
Acute presentation of PID
Degenerating fibroids
UTI: Cystitis
Urinary retention
Constipation
Appendicitis

Question 7

When is cervical excitation positive/present?

Answer 7

Cervical excitation is present when the broad ligament is stretched, in cases such as an ectopic pregnancy

Question 8

What are the signs and symptoms of threatened miscarriage?

Answer 8

• Closed cervical os
• Pain
• PV bleeding
• BUT, ultrasound shows a viable pregnancy with foetal heartbeat detected.

Question 9

What are the signs and symptoms of inevitable miscarriage?

Answer 9

• Opened cervical os
• Pain
• PV bleeding
• Products of conception are seen in ultrasound, with no detectable foetal heart rate

Question 10

What are the signs and symptoms of incomplete and complete miscarriage?

Answer 10

Incomplete miscarriage:

• PV bleeding
• Pain
• Opened cervical os
• Some products of conception seen in uterus, while others are passed out.

Complete miscarriage:

• All products of conception are passed out.
• Pain
• Closed cervical os
• Empty uterus seen on ultrasound

Question 11

What is given to women with profuse PV bleed?

Answer 11

Ergometrine