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Causes and what to do if you feel abdominal pain during pregnancy

Abdominal pain in pregnancy can be caused by the growth of the uterus, constipation or gas, and can be relieved through a balanced diet, exercise or teas.

However, it can also indicate more serious conditions, such as ectopic pregnancy, placental abruption, preeclampsia, or even abortion. In these cases, the pain is usually accompanied by vaginal bleeding, swelling or discharge and in this case, the pregnant woman should go to the hospital immediately.

Here are the most common causes of abdominal pain in pregnancy:

Abdominal pain in the 1º trimester of pregnancy

Causes and what to do if you feel abdominal pain during pregnancy

The main causes for abdominal pain in the first trimester of pregnancy (1 to 12 weeks) are:

1. Urinary tract infection

Urinary tract infection is a very common pregnancy problem that usually arises early in pregnancy.

  • How to identify: causes symptoms like pain in the abdomen, burning sensation during urination, difficulty urinating, urge to urinate even if you have little urine, fever and nausea.
  • What to do: You should go to the doctor to have a urine test to confirm the urinary tract infection and start treatment with antibiotics, rest and fluid intake.

2. Ectopic pregnancy

Ectopic pregnancy occurs due to the growth of the fetus outside the uterus, being more common in the fallopian tubes and therefore can appear during the first 10 weeks of gestation.

  • How to identify: It is accompanied by symptoms such as intense abdominal pain on only one side of the belly and the pain worsens with movement, vaginal bleeding, pain during intimate contact, dizziness, nausea or vomiting.
  • What to do: If you suspect an ectopic pregnancy, you should go to the emergency room immediately to confirm the diagnosis and start the appropriate treatment, which is usually surgery to remove the embryo.

3. Spontaneous abortion

Spontaneous abortion is an emergency situation that usually happens before 20 weeks.

  • How to identify: causes abdominal pain in the lower part of the belly, vaginal bleeding or fluid loss through the vagina, outflow of clots or tissues, and headache. 
  • What to do: Go immediately to the hospital to perform an ultrasound to check the baby's heart rate and confirm the diagnosis. When the baby is dead, a curettage or surgery should be performed to remove it, but when the baby is still alive, treatments can be performed to save the baby.

Abdominal pain in the 2º trimester of pregnancy

Causes and what to do if you feel abdominal pain during pregnancy

Pain in the second trimester of pregnancy (13 to 24 weeks) is usually caused by problems such as:

1. Pre-eclampsia

Pre-eclampsia is characterized by a sudden increase in blood pressure during pregnancy, which is difficult to treat.

  • How to identify: The symptoms are pain in the upper right part of the abdomen, nausea, headache, swelling of the hands, legs and face, and blurred vision.
  • What to do: It is recommended that you go to the obstetrician as soon as possible to check your blood pressure and start treatment with hospitalization because this is a serious situation that puts your life and your baby's life at risk.

2. Placental abruption

Placental abruption is a serious pregnancy problem that can develop after 20 weeks and may lead to premature delivery or abortion depending on the weeks of gestation.

  • How to identify: placental abruption generates symptoms such as severe abdominal pain, vaginal bleeding, contractions and pain in the back.
  • What to do: Go immediately to the hospital to evaluate the baby's heartbeat and perform the treatment, which can be done with medication to prevent uterine contractions and rest. In the most severe cases, delivery may be done before the due date, if necessary.

3. Training Contractions

Braxton-Hicks contractions are training contractions that usually occur after 20 weeks and last less than 60 seconds, but usually cause little abdominal pain.

  • How to identify: The belly becomes momentarily hard, which does not always cause abdominal pain. But in some cases there may be pain in the vagina or at the bottom of the belly, which lasts for a few seconds and then disappears. This pain can happen several times a day. See how to identify pregnancy contractions.
  • What to do: Try to calm down, rest and change position by lying on your side and placing a pillow under your belly or between your legs to feel more comfortable.

Abdominal pain in the 3º trimester of pregnancy

Causes and what to do if you feel abdominal pain during pregnancy

The main causes for abdominal pain in the 3º trimester of pregnancy (25 to 41 weeks) are:

1. Constipation and gas

Constipation is most common at the end of gestation due to the effect of hormones and the pressure of the uterus on the intestine, which slows down its functioning, facilitating the development of constipation and the onset of gas.

  • How to identify: Generates symptoms such as discomfort or abdominal pain on the left side, colics, and the belly may be more hardened where the pain comes from.
  • What to do: Eat high-fiber foods such as wheat germ, greens, cereals, watermelon, papaya, lettuce and oats, drink about 2 liters of water a day, and do light physical exercise such as 30 minute walks at least 3 times a week. See your doctor if the pain does not improve on the same day, if you do not poop 2 days in a row or if other symptoms such as fever or increased pain appear.

2. Pain in the round ligament

The pain in the round ligament arises due to the excessive lengthening of the ligament that connects the uterus to the pelvic region, due to the growth of the belly.

  • How to identify: It causes pain in the lower abdomen that extends to the groin and lasts only a few seconds.
  • What to do: Sit, try to relax and, if it helps, change position to relieve pressure on the round ligament. Other options are to bend your knees under your abdomen or lie on your side placing one pillow under your belly and another between your legs.

3. Labor

Labor is the main cause of abdominal pain in late pregnancy.

  • How to identify: It presents symptoms such as abdominal pain, cramps, increased vaginal secretion, gelatinous discharge, vaginal bleeding and uterine contractions with regular intervals.
  • What to do: Go to the hospital to see if you are really in labor, as these pains can become regular for a few hours, but may disappear completely overnight, for example. Resuming the next day, with the same characteristics. If possible call your doctor to confirm if you are in labor and when to go to the hospital.

When to go to the hospital

Persistent abdominal pain on the right side, near the hip and low fever that can arise at any stage of pregnancy can indicate appendicitis, a situation that can be serious and therefore should be dismissed as soon as possible.

If you suspect appendicitis you should go to the hospital immediately. In addition, you should also go immediately to the hospital or consult your obstetrician that is accompanying the pregnancy when you have:

  • Abdominal pain before 12 weeks of gestation, with or without vaginal bleeding;
  • Vaginal bleeding and severe cramps;
  • Splitting headache;
  • More than 4 contractions in 1 hour for 2 hours;
  • Swelling of the hands, legs and face;
  • Pain when urinating, difficulty urinating or urinating with blood;
  • Fever and chills;
  • Vaginal discharge.

The presence of these symptoms may indicate a serious complication, such as pre-eclampsia or ectopic pregnancy, so it is important for the woman to see the obstetrician or go to the hospital immediately to receive the appropriate treatment as soon as possible.

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