SYMPTOMS

What is abdominal pain during pregnancy?

Abdominal pain during pregnancy refers to abdominal discomfort experienced by pregnant women, also known as "gestational abdominal pain." It may commonly be called "stomach pain during pregnancy" and includes pain caused by pregnancy itself, related conditions, or other abdominal organ disorders. It is one of the most common yet complex symptoms during pregnancy.

Where does abdominal pain occur during pregnancy?

Depending on the underlying cause, abdominal pain during pregnancy may occur in the lower abdomen, upper abdomen, or throughout the entire abdomen.

What causes abdominal pain during pregnancy?

• Pain receptors in the uterine muscle tissue are stimulated during contractions, sending nerve impulses through the spine to the brain, triggering pain perception;
• Signals from stimulated abdominal organs travel via neural pathways to the brain, causing pain;
• Pain signals from the abdominal wall or peritoneum are transmitted through somatic nerves to spinal nerve roots, projecting pain to corresponding skin areas;
• Stretching of abdominal organs stimulates visceral sensory nerves, causing referred pain in related areas.

When does abdominal pain usually occur during pregnancy?

Depending on the cause, abdominal pain may occur at any time—during the first, second, or third trimester.

What types of abdominal pain occur during pregnancy?

Abdominal pain during pregnancy can be physiological or pathological, acute or chronic. The nature of the pain varies significantly based on the cause and severity.

• Preterm labor or labor pain is often caused by regular contractions, presenting as rhythmic, intermittent lower abdominal pain;
• Placental abruption typically causes persistent abdominal pain without clear contraction intervals;
• Acute abdominal pain may manifest as continuous, tearing pain;
• Chronic abdominal pain often presents as dull, poorly localized, diffuse discomfort.

Is abdominal pain without bleeding harmless during pregnancy?

Not all abdominal pain during pregnancy is accompanied by vaginal bleeding. Most inflammatory conditions in abdominal organs do not cause noticeable vaginal bleeding, nor does internal bleeding from ruptured pelvic or abdominal organs.

However, such pain can still significantly impact both the mother and fetus, and delayed treatment may endanger their well-being.

Does abdominal pain during pregnancy affect the baby?

Physiological pain, such as contractions at full term, is a natural part of labor and generally does not harm the fetus.

However, pain caused by pregnancy complications or other abdominal organ disorders may affect both mother and baby, potentially leading to miscarriage, preterm birth, or stillbirth.

TREATMENT

How to relieve abdominal pain during pregnancy?

Since the causes of abdominal pain during pregnancy are complex and varied, and most cases are likely pathological, it serves as a warning signal from the body. It is advisable to seek medical attention promptly to determine the cause and then decide on the appropriate treatment.

Blindly waiting for recovery at home or self-administering painkillers or antispasmodic medications is not recommended.

Can warm compresses be used for abdominal pain during pregnancy?

The causes of abdominal pain during pregnancy are complex and diverse, and warm compresses do not alleviate it. Therefore, applying warm compresses is not advised when experiencing abdominal pain during pregnancy.

Can brown sugar water be consumed for abdominal pain during pregnancy?

Before identifying the cause of abdominal pain, drinking brown sugar water is not recommended. For patients requiring emergency surgery, consuming brown sugar water may delay the optimal timing for the procedure.

DIAGNOSIS

Should all abdominal pain during pregnancy require a hospital visit?

Due to the complex and varied causes of abdominal pain during pregnancy, as well as the significant uncertainty in disease progression, failure to address it promptly may impact the health and safety of both the pregnant woman and the fetus. Therefore, it is recommended to seek medical attention promptly for any abdominal pain during pregnancy to identify the cause and receive targeted treatment.

Under what circumstances should pregnant women seek medical attention for abdominal pain?

Pregnant women should go to the hospital immediately if abdominal pain is accompanied by the following symptoms or conditions:

• Regular, intermittent lower abdominal pain
  This usually indicates threatened or preterm labor, suggesting the fetus may be delivered soon. Immediate medical evaluation and obstetric care are necessary.

• Vaginal bleeding
  This often suggests a high likelihood of threatened miscarriage or ectopic pregnancy, which are gynecological emergencies requiring prompt medical attention.

• Persistent abdominal pain with nausea and vomiting
  This may indicate conditions such as red degeneration of uterine fibroids, torsion or rupture of pelvic masses during pregnancy, acute fatty liver of pregnancy, urinary tract infections, appendicitis, or gastroenteritis.

POTENTIAL DISEASES

What Causes Abdominal Pain During Pregnancy?

The causes of abdominal pain during pregnancy can be divided into two main categories: pain caused by pregnancy itself and pain caused by abdominal organ disorders during pregnancy. These are briefly described below:

1. Abdominal Pain Caused by Pregnancy Itself

• Pain Due to Uterine Contractions
  Regular contractions present as intermittent, rhythmic pain with consistent duration and intervals, often accompanied by a tightening or hardening sensation in the abdomen.

• Miscarriage
  This can occur in early or mid-pregnancy, often accompanied by irregular vaginal bleeding. If treated promptly, the pregnancy may continue. However, if tissue is expelled or bleeding worsens despite treatment, it may progress to an inevitable miscarriage.

• Ectopic Pregnancy
  Symptoms include vaginal bleeding and abdominal pain after a missed period. Before rupture, there is often dull or aching pain on one side of the lower abdomen. If the ectopic pregnancy ruptures or miscarries, it may cause sharp, tearing pain on one side, along with nausea and vomiting.

• Pregnancy with Uterine Fibroid Degeneration
  Due to hormonal changes, fibroids may grow rapidly during pregnancy, leading to vascular rupture and hemorrhage within the fibroid tissue, causing red degeneration. This often results in sudden, severe pain on one side when changing positions, accompanied by nausea and vomiting.

• Pregnancy with Torsion of Gynecological Tumors
  Common conditions include torsion of benign ovarian tumors or subserosal uterine fibroids. A typical symptom is sudden, severe pain on one side of the lower abdomen during pregnancy.

• Uterine Rupture
  This is more common in late pregnancy, particularly in women with a history of cesarean section or uterine surgery. It may present as sudden, severe abdominal pain, followed by paleness and cold sweats.

• Placental Abruption
  Symptoms include sudden, persistent abdominal pain, backache, or lower back pain, often with little or no vaginal bleeding.

• Severe Preeclampsia
  Severe preeclampsia can cause significant liver damage or subcapsular hematoma, leading to right upper abdominal pain.

• Acute Fatty Liver of Pregnancy
  Although rare, this condition has a high fatality rate and typically occurs in late pregnancy. Symptoms include sudden, persistent nausea, vomiting, and severe upper abdominal pain, followed by worsening jaundice within a week.

2. Abdominal Pain Caused by Organ Disorders During Pregnancy

• Pregnancy with Acute Gastritis
  Early symptoms often include dull upper abdominal pain, with hematemesis and melena in severe cases. Excessive bleeding may lead to anemia.

• Pregnancy with Peptic Ulcer
  Pain is typically located in the mid-upper abdomen, with a clear correlation to eating patterns and a recurring nature. Many patients have a history of peptic ulcers before pregnancy and may also experience heartburn, regurgitation, or acid reflux.

• Pregnancy with Acute Cholecystitis
  Often triggered by fatty meals or occurring at night, symptoms include severe colicky or distending pain in the right upper abdomen, radiating to the right shoulder or back, along with nausea, vomiting, fever, or even chills.

• Pregnancy with Pancreatitis
  Pain is usually in the mid-abdomen or upper right/left abdomen, fluctuating in intensity and worsening after heavy or fatty meals. Nausea and vomiting are common.

• Pregnancy with Acute Appendicitis
  In early pregnancy, pain typically starts in the upper abdomen, moves to the navel, and then localizes in the right lower abdomen, accompanied by nausea, vomiting, and bloating. In later stages, pain may be less pronounced due to uterine displacement.

• Pregnancy with Intestinal Obstruction
  Main symptoms include colicky pain, vomiting, and bloating. Complete obstruction may also cause cessation of bowel movements and gas passage.