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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 especially if
abdominal pain or cramping associated 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) .
The most common causes of abdominal pain and discomfort during
pregnancy,
Gas and bloating
gas pain and bloating during pregnancy because of hormones that slow
digestion and the pressure of growing uterus on stomach and intestines.
Constipation
Constipation is another common cause of abdominal discomfort
throughout pregnancy
Round ligament pain
Round ligament pain is generally a brief, sharp, stabbing pain or a
longer-lasting dull ache that may feel on one or both sides of lower
abdomen or deep in groin, usually starting in second trimester. It
happens when the ligaments that support uterus in pelvis stretch and
thicken to accommodate and support its growing size.
Braxton Hicks contractions
Sometime after mid pregnancy, may start to notice some tightening in
uterus from time to time. Before 37 weeks, these Braxton Hicks
contractions should be infrequent, irregular, and essentially painless.
What serious problems can cause abdominal pain during
pregnancy?
A….Conditions Incidental to Pregnancy
1….Gastrointestinal causes of acute abdomen that are incidental to
pregnancy include the following:
Bowel obstruction
Bowel perforation
Herniation
Meckel diverticulitis
Pancreatic pseudocyst
2….Genitourinary causes of acute abdomen that are incidental to
pregnancy include the following:
Ovarian cyst rupture
Adnexal torsion
Ureteral calculus
Rupture of renal pelvis
Ureteral obstruction
3….Vascular causes of acute abdomen that are incidental to pregnancy
include the following:
Superior mesenteric artery syndrome
Thrombosis/infarction - Specifically, mesenteric venous thrombosis
Ruptured visceral artery aneurysm
Splenic artery aneurysm
4….Respiratory causes of acute abdomen that are incidental to pregnancy
include the following:
Pneumonia
Pulmonary embolism
5….Additional causes of acute abdomen that are incidental to pregnancy
include the following:
Intraperitoneal hemorrhage
Splenic rupture
B….Conditions Associated With Pregnancy
1….Pregnancy-associated conditions that cause acute abdomen include
the following:
Acute cystitis
Acute fatty liver of pregnancy
Rupture of rectus abdominis muscle
Torsion of the pregnant uterus
2….Due to pregnancy
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.
Miscarriag:- 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.
Preterm labor:- (also known as premature labor) if there are
contractions that efface or dilate cervix before 37 weeks of pregnancy.
Urinary tract 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), foul-smelling, or
bloody urine.
Conditions resulting from pregnancy that cause acute abdomen in
early pregnancy include the following:
Ruptured ectopic pregnancy
Septic abortion with peritonitis
Acute urinary retention due to retroverted gravid uterus
Conditions resulting from pregnancy that cause acute abdomen in later
pregnancy include the following:
.
Red degeneration of myoma :- occurs in 5-10% of pregnant women
with myomas. Degenerating myoma often occurs between 12 and 20
weeks' gestation.
Rupture or torsion an overian cyst mostly pain associated with
sweating , nausea and vomiting . An ultrasound scan will help in
confirming the cause of the physical discomfort .
Torsion of pedunculated myoma
.
Placental abruption :-is a life-threatening condition in which placenta
separates from uterus, partially or completely, before baby's born.
Placenta percreta
HELLP (hemolysis, elevated liver function, and low platelets) syndrome
Spontaneous rupture of the liverChorioamnionitis
.
Uterine rupture Uterine rupture:- Symptoms of uterine rupture
include the following: ((Severe abdominal pain, Chest pain from
hemoperitoneum, Nonreassuring fetal heart rate pattern, severe
bradycardia (most common sign),Loss of station of presenting
part,Vaginal bleeding , Hypovolemia, Possible history of prior uterine
surgery or uterine anomaly )) .
Diagnosis is clinical. Ultrasonography may be useful if it is immediately
available.
Delivery immediate cesarean delivery with probable hysterectomy.
Repair of the uterus may be possible in select cases. Blood products may
be needed.