Acute pelvic pain is one of the most common reasons women present to the emergency room for evaluation. Patients should have a thorough evaluation to rule out a surgical emergency and to assess hemodynamic stability. Blood pressure and pulse should be monitored immediately. Unstable patients should be appropriately resuscitated following the ABCs of trauma protocols. Immediate vascular access should be obtained and prompt administration of isotonic fluids instituted to correct volume deficits. Once the patient is stabilized, continued evaluation of the physical exam should follow. If peritoneal signs are present (rigid abdomen, rebound, involuntary guarding), surgical evaluation should be considered.
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