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).