Event 3: Pain Narrative


Ava, a 28-year-old Puerto Rican pregnant woman

Ava developed anterior pelvic pain over the past few weeks. Her pain narrative can be summed up as follows:

  • Feels stabbing, sharp, with a residual aching
  • Worst right over midline pubis and base of stomach, radiates into back and medial legs at times
  • Intense with walking, better at rest, ranges from 8 out of 10 to 2 out of 10
  • Started with mild pain first day, worse of ensuring days, now almost incapacitating
  • Much worse with walking, carrying her toddler is very painful
  • Relieved by reclining, somewhat better with sitting than walking, acetaminophen is barely helping


  • 5 months ago: First OB-GYN visit, initial labs drawn.
  • 3 weeks ago: Felt a twinge, then a mild, but stabbing and sharp pain first presented.
  • 2 weeks ago: Pain worsened, became more uncomfortable to walk, pain began to radiate to back and medial legs.
  • Several days ago: Pain became intense if she was walking for longer periods of time, better with rest. Ranges from 2 out of 10 at best to 8 out of 10 at worst. Pain also aggravated by carrying her toddler.
  • Yesterday: Had regularly scheduled appointment with OB-GYN, everything confirmed normal with the pregnancy. Found pain to be better with reclining, acetaminophen.
  • Today: Pain became completely unbearable, came in for urgent clinic visit staffed by nurse midwife.

Pain Features


Anterior pelvic area: symphysis pubis


Stabbing, sharp


Worsening over day, occurring sporadically


8 with movement, 2 at rest

Extracted Pain Synopsis

Ava is a 28-year old Hispanic female who is 7 months pregnant, and has developed a progressively severe anterior pelvic pain that is worsening with walking.

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