Original Publication
Open Access

"My Belly Hurts": Approaching Abdominal Pain in the Pregnant Patient - A Problem-Based Learning Module

Published: July 2, 2013 | 10.15766/mep_2374-8265.9459

Included in this publication:

  • MBH - Facilitator's Guide.docx
  • MBH - Instructor's Guide.docx
  • MBH - Student Feedback Form.docx
  • My Belly Hurts Presentation.pptx

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Introduction: Traditionally, the third- and fourth-years of medical school are dedicated to developing clinical knowledge. This problem-based learning (PBL) case is designed with the idea of maintaining focus on relevant basic science content as students advance their clinical science training. The case grew out of inpatient OB-GYN experiences. The case reviews basic science concepts around changes in physiology in pregnancy and urinalysis to help students improve clinical knowledge about pyelonephritis, a serious condition in pregnancy. Methods: This module is a slide presentation-based case intended for third-year medical students who are enrolled in their OB-GYN clerkship. Groups of students work together with the assistance of an expert facilitator to examine, discuss, and learn from each other using the content of the case as support. The case itself follows the evaluation of a pregnant patient with abdominal pain, through her diagnosis with acute pyelonephritis, to her treatment and cure. Results: In gauging the educational value of our work, we decided to collect feedback using a survey form. The form was completed at the end of activity and asked students to evaluate how well they believed the module achieved the stated goals. Overall, students strongly and consistently stated that the module supported the learning objectives. Qualitative feedback from students directed the authors to include more supportive information in the facilitator's guide. Discussion: The authors regret that there is no pre- and post-module assessment data to share. When originally designing the module, we found that time constraints prohibited this form of assessment. Additionally, examining clerkship shelf scores was also unreliable due to the nature of clerkship scheduling at our institution.

Educational Objectives

By the end of this module, learners will be able to:

  1. Generate a differential for abdominal pain in a pregnant patient that accomplishes the following: (1) includes both OB-GYN and non-OB-GYN causes of pain, (2) considers timing of presentation in pregnancy, and (3) distinguishes urgent conditions from non-urgent conditions.
  2. List and explain the timing and purpose of routine prenatal labs and studies, as well as make predictions about which studies have been completed based upon the patient’s gestational timing.
  3. Define asymptomatic bacteriuria, explain its clinical significance in pregnancy, and describe its management in the pregnant patient.
  4. Explain methods of diagnosing and management, as well as identify risk factors and complications of acute pyelonephritis in pregnancy.
  5. Compare and contrast systemic inflammatory response syndrome, sepsis, shock, and severe shock.
  6. Describe the microbiological/biochemical nature of the elements of urinalysis that aid in the diagnosis of an urinary tract infection (UTI) as well as identify factors that limit the effectiveness of urinalysis in diagnosing UTI.
  7. Explain how these changes place pregnant patients at risk for UTIs.

Author Information

  • Aaron Taylor: Case Western Reserve University School of Medicine
  • Isaac Schwartz: Case Western Reserve University School of Medicine
  • Dov Shalman: Case Western Reserve University School of Medicine

None to report.

None to report.


Taylor A, Schwartz I, Shalman D. "My belly hurts": approaching abdominal pain in the pregnant patient - a problem-based learning module. MedEdPORTAL. 2013;9:9459. https://doi.org/10.15766/mep_2374-8265.9459