Lower abdominal pain during pregnancy
definition
The lower abdomen is the soft area of the abdomen that is located below the navel and above the groin and pubic bone. Pain in this area can be acute or cause chronic problems. The pain is described as stabbing or pulling, in many cases as diffuse over the entire abdomen.
Pregnancy itself is rarely the cause of pelvic pain. At the risk of rare but very dangerous complications of pregnancy, the pelvic pain must be clarified in any case.
causes
The causes of pelvic pain can be divided into organic and non-organic complaints. Non-organic causes are rarely responsible for pelvic pain. These include skin complaints, muscle strains in the abdominal wall and ligament strains in the groin. Muscle cramps can also occur there, whereas the bowel is often the cause here too. More often, however, the numerous abdominal and pelvic organs in the lower abdomen are responsible.
Read more on the topic: Cramps during pregnancy
If you have pelvic pain during pregnancy, you should first think about the intestines. Parts of the small and large intestines are located in this area and can become inflamed or have certain diseases. Even slight digestive problems, stomach cramps or constipation lead to pain. One type of bowel inflammation that is very common is inflammation of the appendix, a small piece of colon that is located in the lower right abdomen.
Read more on the topic: Flatulence in pregnancy, constipation in pregnancy
Inflammation of the bowel in the small or large intestine can be triggered by pathogens or without an apparent cause. Frequent chronic intestinal inflammations are ulcerative colitis or Crohn's disease. Diverticulitis is also a possible trigger. In addition to the inflammation, any intestinal diseases in this section can trigger pain. These include hernias, intestinal infarctions, tumors, intolerance and other diseases.
Read more on the topic: Inguinal hernia of the woman
Pelvic organs can also cause pain in the lower abdomen. The urinary bladder can be found in the female body directly in front of the uterus. If there is inflammation, stones or irritation of the urethra or the bladder, those affected often describe a pain in the lower abdomen.
Read more on the topic: Cystitis During Pregnancy
In some cases, especially during pregnancy, the uterus can be the cause of lower abdominal pain. Occasional pelvic pain is not uncommon during the first few months of pregnancy. Instead of the lack of monthly menstruation, there are occasional stabbing or cramping pains. These pains can also occur at the end of pregnancy and can be interpreted as labor pains. However, it is dangerous in the case of extremely severe pain, which is accompanied by bleeding or fever. In severe cases, these can indicate an impending miscarriage. In order to rule out this dangerous complication, all pelvic pain during pregnancy must be clarified.
Read more on the topic: Signs of miscarriage
diagnosis
The diagnosis of pelvic pain during pregnancy is carried out in several steps. First of all, a precise questioning of the occurrence, type and time of the pain should provide a possible suspected diagnosis. To narrow down the causes in the lower abdomen, it is crucial whether the pain is on the right, in the middle or on the left.
This is followed by a physical examination. The exact localization of the pain is determined and a scan can be used to determine whether the intestine is mobile, hardened or cramped. An ultrasound examination can then be carried out. In particular, inflammation of the bowel, such as the appendix, is diagnosed with the help of ultrasound. Radiological imaging, such as CT, is put on the back burner in pregnancy, as the rays can influence the growing child. Overall, during pregnancy, both diagnostics and treatment must be proceeded differently in order to be as gentle as possible for mother and child.
Can this be a sign of pregnancy?
Lower abdominal pain is also often described as one of the first signs of pregnancy. The monthly pain, together with the menstrual period, stops in pregnancy as soon as the egg is fertilized. However, in early pregnancy, many women describe a feeling like normal menstruation, only without bleeding. Even regular, monthly pelvic pain does not speak against pregnancy. Only the bleeding does not occur during pregnancy. If not, however, it can be a dangerous complication of pregnancy.
As a rule, the pelvic pain should only occur at the beginning of pregnancy. If the pain persists and is particularly severe, a doctor should be consulted.
Read more on the topic: Pregnancy symptoms
Concomitant symptoms
Lower abdominal pain can take several forms. With many intestinal complaints, but also with uterine complaints, pain with strong muscular cramps occurs. The abdomen is palpably hardened on the outside. An accompanying symptom that urgently needs clarification is the loss of blood in the case of cramps in the central lower abdomen during pregnancy.
Read more on the topic: Bleeding during pregnancy, spotting during early pregnancy
With many bowel diseases, drawing and stabbing pains can occur, which are particularly found on one side. This is mostly due to inflammation, which can also make the pain worse when touched and pressed. In appendicitis, the pain can be provoked enormously by movement and pressure in the right lower abdomen. Accompanying symptoms can include fever, fatigue and body aches.
Read more on the topic: Fever during pregnancy
You might also be interested in: Burning in the lower abdomen - these are the causes!
nausea
Nausea is the feeling that is often associated with vomiting. The nausea can indicate gastrointestinal distress. The stomach reacts with irritation of the mucous membranes and nausea, especially when eating certain foods. Nausea also occurs with pathogen-related infections of the gastrointestinal tract, which, depending on the location of the intestinal inflammation, can also lead to pelvic pain.
During pregnancy, nausea with pelvic pain can also occur. This constellation of symptoms is even very typical for the first few weeks to months of pregnancy. The hormonal changes lead to nausea, which occurs especially in the morning, with slight cramp-like pelvic pain in the uterus.
Read more on the topic: Nausea During Pregnancy, Homeopathy For Nausea During Pregnancy
Lower abdominal pain on the right
The differentiation of the sides is groundbreaking in the diagnosis of pelvic pain. The organs that are potentially affected, which can be found on the right side of the lower abdomen, are mostly sections of the small and large intestines, as well as the appendix. The appendix is also the most common source of pelvic pain. These can become so severe that patients cramp and hunch on their right side in pain.
Chronic intestinal diseases or complaints of the pelvic organs can also cause pain in the right lower abdomen, which is why they should not be disregarded in the diagnosis.
Lower abdominal pain on the left
Pain in the lower abdomen, which can only be felt on the left side, is often caused by the gastrointestinal tract. The end of the colon, called the "Sigmoid“Is located in this area. This is a common site for inflammation and chronic illness. The two most important chronic inflammatory bowel diseases, which are also preferred in this area, are ulcerative colitis and Crohn's disease. So-called diverticulitis is also often found in this area.
The left colon area can be examined very well with the help of a colonoscopy. In the event of complaints, this can be carried out in almost all hospitals. Colon tumors are also often found in this area. For men over 55 years of age, regular colonoscopy is recommended for this area for the early detection of malignant diseases.
treatment
Treatment depends on the cause of the pelvic pain during pregnancy. It is important, however, to proceed more carefully and less invasively in the diagnosis and treatment of pregnant women.
In the case of inflammation of the intestine, for example the appendix, attempts should be made to get the disease under control with home remedies and light medication. An operation of the appendix involves certain risks during pregnancy, but is inevitable in an absolute emergency if there is a risk of a breakthrough.
Read more on the topic: Anesthesia during pregnancy - important information
For drug therapy of various diseases during pregnancy, some drugs are recommended, while others must be avoided. The use of medication must be discussed in detail with a doctor. If there are cramps in the uterus with bleeding, a gynecologist should be consulted immediately.
Read more on the topic: Paracetamol in pregnancy, drugs during pregnancy
Duration
The duration of the cramps also varies with the cause. Slight pelvic pain, which can occur at the beginning of a pregnancy, should subside after 4-5 days at the latest. If the cause is appendicitis, the symptoms should go away after about a week. In the case of chronic intestinal diseases, the duration cannot be precisely estimated. This inflammation often lasts for a few months, sometimes even years. With therapy, however, you can live with these largely symptom-free.
In early pregnancy
At the beginning of a pregnancy, occasional pelvic pain is not a cause for alarm. Just as period pain occurs regularly, slight cramps can set in during pregnancy every month. However, as the pregnancy progresses, these should decrease. Only if the pain persists for a particularly long time or appears extremely severe, other causes must be ruled out. Bleeding with cramps during pregnancy must also be clarified and treated immediately.
When to the doctor
As a rule, mild abdominal pain often has harmless causes. At your own discretion, you should decide how many days a pain should last and how severe the pain can still be described as normal. In general, more caution must be taken during pregnancy, as the body is more prone to and sensitive to some diseases.
Important factors for which it is essential to see a doctor are bleeding, fever, aching limbs or severe cramps that occur together with pelvic pain.
