Abdominal Pain in Pregnancy

Abdominal Pain in Pregnancy is a common symptom, which often causes great anxiety. However, this is unfounded in most cases as mild abdominal pain in the lower abdomen are not uncommon. The causes of the pain are very different and, despite everything, need to be clarified by a doctor . Other symptoms such as bleeding , painful urination , fever and chills should be examined by a doctor.

abdominal pain in pregnancy

Causes

Especially at the beginning of a pregnancy , a change in the body can cause pain. These are caused by stretching of the various ligaments and muscles of the uterus ( uterus ), which adapts to the new situation. In addition, the growth of the uterus causes increased space in the abdomen, which can cause discomfort and spasms in the abdomen . Furthermore, especially at the beginning often the pregnancy hormones ( ß-HCG ) are not yet sufficiently available and the uterus is prone to contractions, which can cause pain in the abdomen.

In later stages of pregnancy, even kicks or an unfavorable position of the child can lead to pain. But also labor pains are normal in the last trimester and only serve the uterus to prepare for the birth. However, these practice pains have no influence on the cervix and are not intended to initiate childbirth. For this reason, they must be distinguished from birth-relevant forerunners, which can initiate the birth and cause premature birth .

In addition to the harmless causes of the adaptation processes in the body, but the cause can also be different origin. Especially at the beginning of a pregnancy that has not yet been confirmed , it can be an abdominal cavity pregnancy (extrauterine pregnancy). First, the symptoms of a normal pregnancy occur:

  • The menstruation is missing
  • morning sickness and
  • Tensions of the chest

Even a pregnancy test is positive in this case. However, due to the location of the fertilized ovum outside the uterus, inflammation occurs and the ovum can burst with increasing size. In this case, the Abdominal Pain in Pregnancy is acute and very strong. This is followed by a brief, symptomless interval with increasingly dull pain throughout the abdominal area. Since in this case the entire abdominal cavity can catch fire, it is important to exclude such an abdominal cavity pregnancy with the help of an ultrasound device at the beginning of a pregnancy.

If the pain occurs along with bleeding at the beginning of pregnancy, a doctor should also be consulted as in some cases the symptoms are associated with abortion .

Another possible cause of the Abdominal Pain in Pregnancy is an adnexitis (tubal inflammation). It is an inflammation usually caused by chlamydia , which can ascend into the fallopian tubes and become symptomatic there. Patients complain of pulling in the abdomen and oppressive pain in the area of ​​the abdomen. Furthermore, it may also come to accompanying symptoms, such as fever, etc.

An ovarian cyst can also be responsible for the pain. A cyst of the ovary may be unnoticed and symptom-free for a long time before discomfort occurs. In this case, it can also come in the back pulling stomach pain .

Flatulence in pregnancy can also be considered as a cause: The bigger the child becomes, the more space in the abdominal area is filled. This also results in different pressures beingexertedon the gastrointestinal tract as well as on the blood vessels.

While the so-called vena cava compression syndrome can be triggered in the supine on the back ( reduced blood flow back to the mother), the child’s increasing pressure on the maternal abdominal organs can also lead to dysbalances in maternal digestion .
This can lead to abdominal discomfort, which is initially not interpreted as flatulence , but their medical significance is harmless.

In addition, pain can occur regardless of pregnancy. Thus, appendicitis , a strong bladder infection or a gastrointestinal upset can also lead to abdominal pain. In this case, always pay attention to the accompanying symptoms.

Internal causes

Abdominal pain, which is based on internal medical conditions , are manifold and often not clearly distinguishable . The most common diseases are inflammation of unnoticed intestinal linings ( diverticulitis ), inflammation of the pancreas ( pancreatitis ), biliary colic, renal colic, appendicitis ( appendicitis ), intestinal obstruction ( ileus ), gastric or duodenal ulcer ( ulcus ventriculi , duodenal ulcer ), infarct of the intestine supplying blood vessels( Mesenteric infarction ) and outlines of the main artery ( aortic aneurysm ).

Depending on which underlying medical conditions lead to abdominal pain, the diagnosis and the therapy are different . In general, it can be stated that the complaints concern the abdominal area. The pain character is different , ranging from acute tearing to dull pain to wave-shaped, colicky pain.

symptoms

A slight tugging in the lower abdomen , similar to that during menstruation , without bleeding, is usually harmless and merely signs of changes in the uterus.

Nevertheless, this should also be confirmed by a doctor to avoid abortion . In particular, too little amount of pregnancy hormones can cause contractions of the uterus and possibly lead to a miscarriage .

If pain occurs in the later part of the pregnancy, a distinction must generally be made between child movements, exercise labor and premature labor .

Kicking the child against the abdominal wall or an unfavorable position of the child, especially if the space in the abdomen is significantly lower, can be very painful. However, as a result of a change in the position of the mother or a rearrangement of the child, the pain usually ceases.

This type of pain also differs from contractions, as the pain does not occur regularly, and can be significantly shorter or stopped by rearrangement.

Exercise labor is normal especially in the third part of pregnancy and is used to prepare the uterus for childbirth. However, they are not relevant to birth and do not lead to the opening of the maternal . Just like real birth pains, these are contractions that go along with a hard stomach. They differ from birth-related labor, as they only last a maximum of 45 seconds and do not occur more often than 3 times an hour.

For a clear distinction, a CTG can be applied to the gynecologist or the hospital. This shows both the labor activity and the heart activity of the child.

Right sided Abdominal Pain in Pregnancy

Abdominal Pain in Pregnancy is not uncommon and in most cases completely harmless. Nevertheless, cramps and / or Abdominal Pain in Pregnancy that occur during pregnancy can have serious causes and make a prompt visit to the doctor necessary.

In general, most women assume that Abdominal Pain in Pregnancy is directly related to the growing up of the child. However, Abdominal Pain in Pregnancy can have completely different causes during pregnancy.
Take special care with pain and / or convulsions Abdominal Pain in Pregnancy that occur suddenly and have a sharp / piercing quality.

Pregnancy-associated abdominal pain, ie those pain directly related to pregnancy, is most often perceived by most women on the right . Reason for the occurrence of this abdominal pain right is usually an overuse of various structures.

As the child grows in the womb, muscles, ligaments, tendons, vessels, and organs are compromised in a particular way. In particular, the individual bands within the abdomen are greatly stretched Abdominal Pain in Pregnancy.
For this reason, it may cause intermittent abdominal and abdominal pain throughout pregnancy (see: Pain in the Abdominal Pain in Pregnancy ) come.

The fact that these complaints are mainly observed on the right can be explained by the fact that the uterus (uterus) shifts slightly to the right during pregnancy. The stress on the ligaments, tendons and muscles is accordingly particularly pronounced on the right. In order to counteract common abdominal pain on the right side, women should be careful to move sufficiently during pregnancy.

In the case of acute abdominal pain on the right, the expectant mother should sit down if possible and take a relaxed posture. In addition, the woman suffering from abdominal pain should lie down during the acute pain phase. Many pregnant women find the tilting of the body to the unaffected half of the body particularly pleasant.

In Abdominal Pain in Pregnancy, which occur especially on the right, but also organic causes should be clarified. This is especially recommended if, despite rest break, no improvement occurs or the symptoms increase with increasing pregnancy intensity.

Abdominal Pain in Pregnancy can be caused by , among other things, gallbladder disease. The severe impairment of the hormone balance may, for example, lead to the formation of gallstones and a concomitant displacement of the bile ducts. In addition, right Abdominal Pain in Pregnancy may be due to inflammation of the gallbladder . In addition, right-sided Abdominal Pain in Pregnancy, especially in the lower abdomen, as well as non-pregnant women may be a sign of appendicitis .

Left sided Abdominal Pain in Pregnancy

Abdominal Pain in Pregnancy can also be caused by excessive stretching of ligaments, tendons and muscles .
Although the uterus usually tilts slightly to the right after implantation of the fertilized egg, some women show a shift to the left.

Especially at the beginning of pregnancy , many expectant mothers experience abdominal pain that occurs on the left. In most cases, this pain is a completely harmless symptom that does not require any medical intervention.

Colloquially, in connection with abdominal pain, which are perceived on the left (or right) in early pregnancy, one speaks of an indication of the stretching of the ” mother ligaments “. In the end, this means nothing more than changing the position of the uterus and making room for the child to grow up.

In addition, abdominal pain on the left in the first weeks of pregnancy can be triggered by the change in hormone balance .

If the symptoms occur more frequently or steadily increase in intensity, a specialist should be consulted promptly and the cause of the complaints clarified. In some cases, the cause of abdominal pain is left (or right) in a so-called ectopic pregnancy . In this disease occurs after fertilization of the egg to a faulty implantation within the fallopian tube .

An ectopic pregnancy is a potentially life-threatening condition as the rupture of the affected fallopian tube causes severe bleeding . Also on the left, such abdominal pain can occur during pregnancy, which basically have nothing to do with the growing up of the child. Also, recurrent abdominal pain on the left should urgently be medically clarified.

Abdominal pain left, for example, can be caused by diseases of the left kidney . An impairment of the right kidney would lead to abdominal pain on the right side of the pregnant woman. In this context, the expectant mother should pay attention to additional symptoms. An inflammation of the kidneys and / or the draining urinary tract is usually noticeable by severe urinary symptoms .

An examination of the urine can give an indication of the presence of a bacterial infection within a few minutes. In addition, Abdominal Pain in Pregnancy on the left, even during pregnancy, may be an expression of inflammatory processes in the region of the large intestine or an infection of the gastrointestinal tract.

Other reasons for the development of Abdominal Pain in Pregnancy that occur on the left or right of the belly button are:

  • tubal inflammation
  • diverticulitis
  • ureteral stones
  • Inflammation of the pancreas ( pancreatitis )
  • Spleen diseases
  • Ovarian cysts in pregnancy

Abdominal Pain in Pregnancy in the upper abdomen

Upper Abdominal Pain in Pregnancy are nothing unusual. However, if the pain persists for a long period of time, a doctor should be consulted for safety assessment .

If the ongoing pain is pain in the right upper abdomen , the attending physician will clarify whether a so-called HELLP syndrome exists. In a HELLP syndrome, there is an increased blood clotting , as well as an increased reduction of red blood cells. As a result, blood clots form, leading to damage especially in the liver , so that the liver values ​​increase.

Since the liver is located in the right upper abdomen, Abdominal Pain in Pregnancy in the right upper abdomen may be a symptom of liver capsule tension .

A HELLP syndrome typically occurs as a pregnancy complication in the third trimester of pregnancy .

Upper Abdominal Pain in Pregnancy on the left side may, for example, speak of a kidney infection . Often, however, the reason is quite harmless and the upper abdominal pain is a sign of often associated with a pregnancy constipation . But even a strong kick of the child in the direction of the stomach of pregnant women may be the cause.

Abdominal pain in early pregnancy

Abdominal Pain in Pregnancy in the early stages of pregnancy , in the first few weeks and months, is nothing unusual.
They are a sign that the body is preparing to house a growing child for nine months.

In the initial phase, the implantation of the fertilized egg in the uterine lining may result in a weak abdominal distension.

Furthermore, at the beginning of the cake ( placenta ) and it comes to the formation of new blood vessels .
Some pregnant women also feel this as a slight pain .

Increasingly there is also an expansion of muscles and ligaments and the uterus grows. All of these can be perceived as pulling pain. Especially the so-called mother straps stretch in the initial phase of pregnancy. The mother straps attach the uterus to the pelvic bone.

The pain is often described as a type of muscle catlike and projected mostly on the groin .
Above all, the application of warmth, rest and relaxation helps against this type of pain.

Sometimes pregnant women go to the doctor only because of the pain and get notified in this context that this is the “consequences” of a pregnancy.

Sometimes pregnant women go to the doctor only because of the pain and get notified in this context that this is the “consequences” of a pregnancy.

blow

Abdominal Pain in Pregnancy that occurs during pregnancy is often an early onset of labor . In the medical jargon one speaks in this context of so-called “practice pains” . Labor contractions that appear as a mild pull or moderate Abdominal Pain in Pregnancy may occur during the 30th week of pregnancy. In general, these practice pains are completely harmless and no cause for alarm.

The expectant mother’s body deliberately triggers labor during pregnancy to prepare the uterus for childbirth, Many women already notice noticeable hardening of the abdominal wall during these mild contractions, which, however, recede after the abdominal pain subsides.

From the 35th week, it can be Abdominal Pain in Pregnancy to so-called “Senkwehen”act. This type of labor causes the child to be pushed deeper into the pelvis.

Sustaches usually occur at completely irregular intervals and are accompanied by pronounced back pain in many women (see also the article Abdominal Pain in Pregnancy and back pain).

Especially young women who are in the first pregnancy, can experience the Abdominal Pain in Pregnancy very violently. As the internal organs (especially the lungs and stomach) shift back down during this type of labor, most women experience a general improvement in their well-being. Senkwehen are considered completely harmless and harmless. If the abdominal pain / cramps occur during pregnancy shortly before the calculated date of birth, then it can be ” real contractions ” .

To distinguish between contractions and real contractions, some features should be known. True contractions induce a strong pulling in the whole abdomen of the expectant mother . As a rule, not just one side of the abdomen is affected. Many women report that contractions radiate to the back and thighs.

Further evidence that the abdominal pain is a labor contract during pregnancy may provide the gaps between cramps.
In real life, the distances become shorter and shorter . In addition, labor is characterized by their occurrence at regular intervals . The duration of true contractions is between approximately30 and 60 seconds . Many women also report that the pain is getting worse.

In addition, attention should be paid to the details of Abdominal Pain at the end of pregnancy. If the abdominal pain is really a labor contract, the bladder jump will be fairly rapid in most cases . In addition, an increasing expansion of the cervix can be observed. As a rule, this gradually becomes thinner and softer and assumes an opening width of about 10 centimeters.

Abdominal pain after eating in pregnancy

Abdominal Pain in Pregnancy that occurs immediately after eating is not uncommon. Almost every woman suffers from this problem at least once during pregnancy.

Affected women should keep in mind that the pregnancy and the growing up of the child are a burden on the organism. As the child in the womb increases in size and the uterus expands for this reason, there is less room for the remaining abdominal organs.

Especially the stomach is exposed to enormous pressure by the growing up of the child. The larger the unborn child becomes during pregnancy, the further the stomach is shifted towards the rib cage .

If Abdominal Pain in Pregnancy occurs during pregnancy after eating, in most cases this phenomenon is due to excessive stomach filling . Because the stomach may not stretch properly during an advanced pregnancy, over-eating may result in Abdominal Pain in Pregnancy after eating.

In addition, there may be a hormonal increase in acid secretion within the stomach during pregnancy . Also for this reason, Abdominal Pain in Pregnancy may occur after eating.

Nocturnal abdominal pain in pregnancy

In the early phase of pregnancy , the body reverses. It comes to the stretching of muscles and ligaments and to the formation of new vessels . Since the body is at rest at night and other functions of the body are rather muted, the body often has more time at night to devote itself to these remodeling processes. As a result, some pregnant women are more likely to suffer from pulling pain at night.

With increasing pregnancy, ie in the course of the third trimester of pregnancy , there may be a vena cava syndrome . The vena cava directs the blood of the human from the body back to the heart. At the end of pregnancy, the uterus is so large that it can compress the vein. This can be manifested by a hardened and slightly aching stomach during the night. In addition, the pregnant women often experience a slight dizziness , nausea and increased heart rate .

Why does the vena cava syndrome typically occur at night? Vena cava syndrome occurs when pregnant women lie supine for extended periods of time.

Therefore, a sleeping position in a lateral position is recommended. By changing the reclining position from the supine position to the lateral position, the symptoms usually disappear again.

Diagnosis of abdominal pain in pregnancy

Especially in the case of suspicion of pregnancy due to first signs of absence of menstruation , morning sickness or general malaise a gynecologist should be consulted to confirm the diagnosis and confirm a correct position of the embryo . A pregnancy testsuch as Clearblue ® is performed by determining the pregnancy hormone ß-HCG and an ultrasound examination of the abdomen.

Other symptoms such as Abdominal Pain in Pregnancy and nausea , bleeding , increasing pain and vomiting are also used for the ultrasound examination . As a result, an intact pregnancy can be confirmed, and other causes, such as appendicitis are excluded. By determining inflammatory parameters in the blood , an inflammatory cause of the pain can be identified.

In addition, a blood test is usually performed in case of complaints , in which signs of inflammation are detected and it is seen whether the pregnancy hormone is still sufficiently formed. A strong reduction in the pregnancy hormone indicates an aborted, unconscious termination of pregnancy (abortion).
In addition to the ultrasound and blood tests, a comprehensive gynecological examination is usually carried out in which the uterine mouth is inspected and displayed and corresponding abnormalities can be seen.

If all gynecological causes of abdominal discomfort have been ruled out, consideration must be given to whether the cause is not due to an internal medical illness . Here, however, some investigation possibilities due to the fruit-damaging diagnostics fall away.

So it must be weighed very strongly, if an ileus is suspected, an x-ray examination of the abdomen should be performed. The radiation could damage the fetus .

In many other medical conditions, such as pancreatitis, can by means of blood count and ultrasoundalready be seen, whether it is a pancreatitis. Even with bile or renal colic the ultrasound can already provide important information.
Lastly, MRI can provide much helpful information during pregnancy . In an MRI there is no radiation exposure to the fetus. Nevertheless, the indication for MRI during pregnancy must be clearly considered.

Abdominal Pain in Pregnancy Therapy / What helps?

Most causes of abdominal pain do not require any form of therapy. Especially contractions at the beginning of a pregnancy are not well treatable, since this is an adaptation of the body to the new circumstances. Early labor, however, must be taken very seriously and may be treated in hospital.

Most of the mothers affected have to keep to a strict bed rest for the remainder of their pregnancy and are treated with medicines containing vapors . If the cervix has opened too early, it can be closed by means of a so-called cerclage on a trial basis to an ascending infectionof the child and to avoid premature birth.

With harmless abdominal pain as part of the adjustment processes in the body often help relaxation measures , such as a warm bath or a hot water bottle . Usually a rest break helps to relax the stressed muscles and ligaments.

The foreskins can also be alleviated by relaxation and calm , deep breaths . However, if it is just the labor pains before birth, they should stop again, not too long ago .

In ectopic pregnancy , which causes severe discomfort, surgical removal of the oocytefrom the fallopian tube must be performed. This is usually done by minimally invasive laparoscopy . If the symptoms of the patient are improving, one can first try to wait for the further course. In general, however, this is followed by an operative removal of fallopian tubes .

Alternatively, it can be attempted by administering medication that the body repels the fetus and so an operative clearance is no longer necessary. In case of tubal inflammation is mostly with anti-inflammatory drugs and analgesicstrying to alleviate the discomfort. Furthermore, a bed rest should be observed by the patient.

The treatment of an ovarian cyst can either waiting controlling done by ultrasound or by a surgical removal (depending on size). However, if the cyst already causes discomfort, early removal should be considered.

If the pain cause of abortion are that must uterus in many cases resolved in order not to cause complications for another pregnancy.

If there is a bladder infection , this can often be treated at the beginning with plenty of fluid. In an advanced stage of inflammation, an antibiotic may need to be used to treat the inflammation. For this purpose, macrolides , cephalosporins or penicillins are used. These have no influence on the unborn child and do not represent any danger or risk.

If appendicitis is the cause of the pain, it must always be operated on as soon as possible to avoid an appendectomy . Surgery in experienced hands does not pose a risk to pregnancy. Also, an abdominal cavity pregnancy must be treated as quickly as possible in order to avoid life-threatening complications .

Summary

Abdominal Pain in Pregnancy is a common and often harmless symptom as a sign of adapting the body to the new situation.

Depending on the week of pregnancy, the causes of abdominal pain can be numerous and are in part completely harmless.

However, so that no serious danger to mother or child arises, a medical presentation is usually useful . Using simple methods such as ultrasound , CTG and the laboratory , the doctor can easily determine whether or not the pain is therapy-related.

Abdominal Pain in Pregnancy
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