Pregnancy, Uncomplicated

Pregnancy, Uncomplicated is a topic covered in the 5-Minute Emergency Consult.

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  • Pregnancy is not a disease process but rather a physiologic state. It involves severe metabolic stresses on the mother to facilitate the growth and development of the fetus.
  • All women of reproductive age with abdominal pain are considered pregnant until proven otherwise even with history of sterilization.
  • The changes in pregnancy occur from the production of large amounts of placental hormones:
    • Placental progesterone and estrogen

Pediatric Considerations
  • Range for menarche in US is 11–15 yr old
  • Pregnant adolescents who present to the ED may be either unaware of the pregnancy or reluctant to admit it:
    • Assume pregnancy in adolescents, regardless of the chief complaint
    • Pediatric pregnancies have an increased risk of obstructive labor


  • Preceding signs and symptoms can be explained by elevations in various hormone levels or changes in anatomy that are a function of the progression of the pregnancy.
  • Placental human chorionic gonadotropin (hCG):
    • Prevents the normal involution of the corpus luteum at the end of the menstrual cycle
    • Causes the corpus luteum to secrete even larger quantities of estrogen and progesterone
    • Elevated hCG levels are responsible for nausea and vomiting.
  • Placental progesterone:
    • Causes decidual cells in the endometrium to develop and provide nutrition for the early embryo
    • Decreases contractility of the gravid uterus and risk of spontaneous abortion
    • Helps estrogen prepare the breasts for lactation
  • Placental estrogen:
    • Responsible for enlargement of uterus, breasts, and mammary ducts
    • Enlargement of female external genitalia, relaxation of pelvic ligaments, symphysis pubis, and sacroiliac joints

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