Features of Abdominal Wall Pain on History:
The questionnaire included a list of ten key descriptors which supported a diagnosis of AWP (Table 2). Nine of these features were condensed from a 2012 publication from van Assen and colleagues (9). The tenth descriptor was derived from our observation that pregnant patients with AWP often describe pain that worsened with fetal movement. For the 139 participants who had unexplained abdominal pain in pregnancy, the average number of symptom descriptors supporting a diagnosis of AWP was 4.06/10 (St dev 2.12, 95% CI 3.71-4.41). Only 1.4% (2/139) of participants with pain had no symptom descriptors of AWP.
As seen in Table 2, The most commonly used AWP descriptor was pain that is “worsened by walking, bending, moving to sit” (72.6%), followed by pain of a “sharp” quality (56.8%), then pain that is “always in the same location” and pain that is “worsened by coughing, laughing, pushing to defecate” (both 45.3%).
Additionally, the number of AWP descriptors each participant used was calculated (Table 2). It was found that participants describing pain that was worsened by lightly pushing the overlying skin used the highest number of other descriptors supporting a diagnosis of AWP at 6.71/10. (st dev 1.82, 95% CI 5.94–7.49). Participants with altered sensation overlying the painful area had an average of 5.78/10 AWP descriptors (st dev 2.75, 95% CI 4.68-6.88) Participants with pain they described as originating from just beneath the skin had an average of 5.63/10 AWP descriptors (st dev 2.16, 95% CI 4.9-6.37).