In the latest Case Record of the Massachusetts General Hospital,
a 27-year-old woman was admitted to a hospital in Ethiopia
because of severe abdominal pain during labor, with cessation of
contractions. She had been in labor at home, pushing for 24
hours. On arrival at the hospital 3 hours later, she was in
shock. A procedure was performed. The differential diagnosis of
abnormal abdominal pain during labor includes pregnancy-related
and pregnancy-unrelated causes. Any acute abdominal events that
can occur in the nonpregnant state can also occur in pregnancy,
often with different signs and symptoms, and these events should
be considered during the evaluation. Acute abdominal pain that
is related to contractions alerts the clinician to consider
mainly those causes that are related to pregnancy. • What is the
typical presentation of chorioamnionitis? The most common cause
of a change in labor pain is chorioamnionitis. Infection of the
amniotic fluid can result in endomyometritis, with uterine
tenderness and pain