| Cause |
Clinical features |
Critical |
Ectopic pregnancy |
Abdominal pain, missed period with subsequent vaginal bleeding |
Ovarian torsion |
Acute, sharp pelvic pain (moderate to severe), adnexal mass, often with nausea and vomiting |
Acute placental abruption |
Vaginal bleeding, abdominal and/or back pain, and uterine contractions, in severe cases with disseminated intravascular coagulation (DIC). Any gestation (peak between 24–26 week) |
Uterine rupture |
Uterine tenderness, peritoneal irritation, vaginal bleeding and abnormal foetal heart rate |
Molar Pregnancy |
Vaginal bleeding, pelvic pain, an enlarged uterus and severe vomiting |
Infection |
Pelvic inflammatory disease (PID) |
Unprotected sex, post coital bleeding, mucopurulent discharge, lower abdominal or pelvic pain, fever |
Other |
Pregnancy |
Early signs & symptoms can include: breast tenderness, vomiting, bleeding, pelvic discomfort |
Dysmenorrhoea |
Crampy and intermittent lower abdominal, suprapubic or back pain, can have associated nausea, vomiting, headache, dizziness or fainting |
Mittelschmerz |
Mild unilateral recurrent midcycle pain, caused by normal follicular enlargement |
Ruptured ovarian cyst |
Sudden, severe, unilateral pelvic pain, can be precipitated by strenuous physical activity |
Spontaneous miscarriage |
Early pregnancy crampy pelvic pain, vaginal bleeding, and passage of some or all of the products of conception |
Endometriosis |
Crampy pelvic pain associated with menses. Depending on its location can be associated with pain on passing stool, urine or during sexual intercourse |
Functional abdominal pain |
Periumbilical or diffuse, variable location, exacerbated by stress, functional impairment out of proportion, chronic duration |