Wednesday, July 4, 2012

Abdominal pain during pregnancy

What Causes Pain During Pregnancy?

Pregnancy is a time when most women are fearful of pain. Pain during pregnancy is often associated with complications or labor and can be a scary thing. However, not all pain during pregnancy signals a problem. Sometimes, women feel pain during pregnancy because of the many changes happening every day.


If pain during pregnancy is associated with bleeding and cramping, it is time to call your obstetrician. In the first few weeks, a slight bit of pain and bleeding are often associated with implantation and the creation of the mucus plug. After that time, typical pain during pregnancy is related to hormonal changes and the growth of the fetus.

When Does Pain During Pregnancy Start?

Pain during pregnancy may start as early as the first week after fertilization. One of the first signs of pregnancy is pain during pregnancy – breast pain. These pains will often subside later in the first trimester or early in the second trimester as the body gets used to the new hormone levels. But, by that time, other pain during pregnancy may begin. Progesterone causes a loosening of ligaments throughout pregnancy and as the abdomen grows this alone can cause pain during pregnancy.

Abdominal pain during pregnancy

Occasional abdominal discomfort is a common pregnancy complaint, and while it may be harmless, it can also be a sign of a serious problem. (Severe or persistent abdominal pain should never be ignored.)

Below we'll describe the most common causes of abdominal pain and discomfort during pregnancy, but don't try to diagnose yourself. If you experience abdominal pain or cramping along with spotting, bleeding, fever, chills, vaginal discharge, faintness, discomfort while urinating, or nausea and vomiting, or if the pain doesn't subside after several minutes of rest, call your practitioner.

  1. Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, typically in one of the fallopian tubes. It may cause some cramping and other symptoms in early pregnancy.

If left untreated, an ectopic pregnancy can be life-threatening. Call your practitioner immediately if you have any of the following symptoms: abdominal or pelvic pain or tenderness, vaginal spotting or bleeding (can be red or brown, copious or scant, continuous or intermittent), pain that gets worse during physical activity or while moving your bowels or coughing, or pain in your shoulder.

If you're bleeding heavily or having signs of shock (such as a racing pulse, dizziness, fainting, or pale, clammy skin), call 911.

   2. Miscarriage

Miscarriage is the loss of a pregnancy in the first 20 weeks. Vaginal spotting or bleeding is generally the first symptom, followed by abdominal pain a few hours to a few days later.

The bleeding may be light or heavy. The pain may feel crampy or persistent, mild or sharp, and may feel more like low back pain or pelvic pressure.

Call your practitioner if you have signs of a miscarriage. If you have severe pain or heavy bleeding, you need to be seen immediately.

  3. Preterm labor

You're in preterm labor (also known as premature labor) if you start to have contractions that efface or dilate your cervix before 37 weeks of pregnancy.

Call your doctor or midwife right away if you're having any of the following symptoms in your second or third trimester (before 37 weeks):

An increase in vaginal discharge or a change in the type of discharge (if it becomes watery, mucus-like, or bloody – even if it's just pink or tinged with blood)

    4. Vaginal spotting or bleeding

Abdominal pain, menstrual-like cramping, or more than four contractions in one hour (even if they don't hurt)

An increase in pressure in the pelvic area

Low back pain, especially if you didn't previously have back pain

   5. Placental abruption

Placental abruption is a life-threatening condition in which your placenta separates from your uterus, partially or completely, before your baby's born.

There's wide variation in symptoms. A placental abruption can sometimes cause sudden and obvious bleeding, but in other cases there may not be any noticeable bleeding at first, or you might have only light bleeding or spotting. Or you might see bloody fluid if your water breaks.

You might have uterine tenderness, back pain, or frequent contractions, or the uterus might contract and stay hard – like a cramp or contraction that doesn't go away. You might also notice a decrease in your baby's activity. Immediate medical attention is a must.

    6. Preeclampsia

Preeclampsia is a complex disorder of pregnancy that causes changes in your blood vessels and can affect a number of organs, including your liver, kidneys, brain, and the placenta. You're diagnosed with preeclampsia if you have high blood pressure and protein in your urine after 20 weeks of pregnancy.

Symptoms may include swelling in your face or puffiness around your eyes, more than slight swelling in your hands, and excessive or sudden swelling of your feet or ankles. (This water retention can lead to a rapid weight gain.)

With severe preeclampsia, you may have intense pain or tenderness in the upper abdomen, a severe headache, visual disturbances (such as blurred vision or seeing spots), or nausea and vomiting. If you have symptoms of preeclampsia, call your doctor or midwife immediately.

    7.  Urinary tract infections

Being pregnant makes you more susceptible to urinary tract infections of all kinds, including kidney infections.

Symptoms of a bladder infection may include pain, discomfort, or burning when urinating; pelvic discomfort or lower abdominal pain (often just above the pubic bone); a frequent or uncontrollable urge to pee, even when there's very little urine in the bladder; and cloudy, foul-smelling, or bloody urine. Call your caregiver if you have any of these symptoms because an untreated bladder infection can lead to a kidney infection and premature labor.

Signs that the infection has spread to your kidneys – and that you need medical attention immediately – include a high fever, often with shaking, chills, or sweats; pain in your lower back or in your side just under your ribs, on one or both sides (and possibly in your abdomen as well); nausea and vomiting; and possibly pus or blood in your urine.

   8.  Other causes

Many other conditions can cause abdominal pain, whether you're pregnant or not. Some of the most common causes of abdominal pain that your practitioner will consider are a stomach virus, food poisoning, appendicitis, kidney stones, hepatitis, gallbladder disease, pancreatitis, fibroids, and bowel obstruction.

Both gallbladder disease and pancreatitis are often a result of gallstones, which are more common during pregnancy. Fibroids may grow during pregnancy and cause discomfort. And the pressure of the growing uterus on previously scarred intestinal tissue may cause bowel obstruction, which is most likely to occur in the third trimester.

Should I Call My Doctor if I Have Pain During Pregnancy?

If there is bleeding, cramping or severe back pain, it is important to call the obstetrician’s office. Most of the time, there are no medical issues, but as the latter part of the pregnancy approaches, these symptoms of pain during pregnancy can signal labor.

What Symptoms Associated with Pain During Pregnancy are Most Important?

The most important symptoms associated with pain during pregnancy are cramping and bleeding. Early in the pregnancy this could be the first signs of an ectopic pregnancy or miscarriage. After the first trimester or so, cramping and bleeding may be associated with pre-term labor or labor.

Women will feel pain during pregnancy, but not all pain is created equal. There are also symptoms associated with pain during pregnancy that women need to watch out for from the first weeks until birth. It is important to notify the obstetrician of any pain during pregnancy either by phone or at the next scheduled appointment. 



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