Why pulls the lower abdomen at 39 weeks of pregnancy and what should I do?

Pregnancy is a special time in the life of every woman. This overwhelming happiness for the future mother is only from the thought that a new life is growing inside her, so warm and native, even if she does not realize this. And on the other hand it's almost 40 weeks of excitement and worry for the life of an unborn baby. And it is not at all surprising when a pregnant woman is so acutely experiencing a situation when she pulls the lower abdomen at the 39th week of pregnancy. What is this: an alarm or just her baby is already hurrying to see the light, not wanting to wait a minute longer?

Causes of the stretching pain in the abdomen at 39 weeks gestation

Since the birth for the penultimate week of pregnancy is considered a variant of the norm, many "good" people advise not to worry much, but to prepare for the baby's early birth. In most cases, this advice will benefit, calming the already tense nerves of a pregnant woman during the prenatal period. But sometimes, it would seem, the right wish can play a cruel joke.

And the whole point is that the causes of the pulling pains in the lower abdomen at the 39th week of pregnancy can be different, and they do not always indicate an approaching encounter with a baby who has appeared. Here you need to pay attention not only to aching pain, which many compare with the pain during menstruation, but also on the accompanying symptoms. But they can often tell what really happens, much more than the pain itself.

The pulling pains in the lower abdomen in the penultimate week of pregnancy are most often associated, of course, with the preparation of the body for an important (and often difficult) event-the birth. Symptoms of the pulling sensations in the lower abdomen at 39 weeks of pregnancy, warning the expectant mother about an imminent meeting with her long-awaited baby, can be as follows:

• The woman periodically feels aching pain in the pelvic region, which is often accompanied by unusual pressure from the inside on the ureter and the external genitalia.
• The abdomen is lowered (of course, this can happen a couple of weeks earlier) and becomes more rigid.
• Periodically appearing traumatic pains, accompanied by blunt, breaking pains in the lower back, may indicate the beginning of false labor, which is also called training or contractions of Breston-Higgs, or be conditioned by the fetal pressure on the pelvic floor of the mother that increases by the end of pregnancy.
• Strong abdominal pressure on the pelvic organs causes loosening of the stool and more frequent acts of urination, with the amount of urine released becoming smaller. Sometimes there is nausea, associated not with eating, but with the position of the uterus before childbirth.
• During the same period, a woman can observe the departure of the "cork" (thick transparent mucus, with or without splashes of blood) that protects the birth canal from infection dangerous to the fetus.
• The weight of the mother can decrease by 0.5-1 kg.
• The baby becomes less mobile and reminds of himself no more than 10-12 times a day.
• The cervix begins to prepare for childbirth (opens).

If a woman feels that she is pulling the lower abdomen at the 39th week of pregnancy, and noticing other symptoms that are harbingers of an early birth, one should not be frightened. It is better to check whether everything is ready for the appearance of a new tenant in the house. But it is not worthwhile to actively move in this period, so as not to rush things. Let everything go its course.

Unfortunately, not always the pulling pains in the lower abdomen are the first signs of the approach of delivery. Sometimes such feelings are associated with pathological processes in the body of a woman who are dangerous both for her and her unborn baby.

Aching pains and heaviness in the abdomen can be a signal of digestion disturbance, and if such pains intensify, adding belching eggs, nausea, vomiting, diarrhea to it, this indicates a poisoning that is possible at any time of pregnancy, but in recent days is especially dangerous.

If aching pains are accompanied by discharge from the vagina, which have a strange color or smell, contain a large amount of blood or pus, this is a signal that there is something wrong with the woman's body. For example, saturated spotting can talk about starting bleeding, the causes of which can be a lot. Probably the most terrible of them in this period is the detachment of the placenta. A disruption of the placenta providing the vital activity of the fetus leads to pathologies of its development due to starvation, intoxication and a decrease in the protective function of the placenta.

The causes of placental abruption can be various cardiovascular and endocrine diseases, disorders in the work of kidney and liver, toxicosis of pregnant women, inflammatory processes in the uterus and the placenta itself. There are also some risk factors that indicate the possibility of exfoliation of the placenta: late delivery, a large number of births, pregnancy after prolonged treatment for infertility, bad habits (smoking, drinking, improper nutrition), allergy to medications, abdominal injuries, predisposition (according to anamnesis). When there are discharge, saturated with blood, it is necessary to call "ambulance" and go to the hospital.

White small allocation most likely will tell about a fungal infection (a thrush), while purulent with a smell - about sexual bacterial infection. In any case, this is an occasion to visit your gynecologist immediately to prevent various complications.

Aching in the lower abdomen may be associated with the perennial problem of pregnant women - constipation. They are dangerous at any time of pregnancy, and what can we say about the last days, when any attempts can provoke the onset of labor.

Various benign and malignant tumors (polyps, fibroids, tumors) can become the causes of aching and pulling pains in the abdomen at the 39th week of pregnancy, and on other terms.

If the weak pain in the pelvic region is accompanied by pain in the lower back, this state of affairs can equally indicate the preparation of the organism for labor (training bouts), and kidney diseases due to hypothermia or increased stress on them during pregnancy, work for two.

Pain in the lower abdomen may be manifested and inflammatory diseases of the pelvic organs, as well as a pathology of pregnant women, such as symphysitis (excessive mobility of the pannus joint, which is caused by the preparation of the organism for childbirth), dangerous for the mother herself, despite the fact that it does not affect the health of the baby influence.

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Pathogenesis

Epidemiological studies suggest that in most cases, pregnant women are pulled by the abdomen at 39 weeks of gestation due to the proximity of births. Why does this happen?

This is not surprising, because in our intelligent world there is no place for chance. If the woman's body was preparing for an important event for 38-39 weeks, why not in the last few weeks to conduct a dress rehearsal ?! Yes, and the baby is already quite ready to come to our world, because he has sufficiently formed all the vital organs and systems. In the womb of the mother's place, it is not enough for him even for normal life activity, but what can we say about active movements with pens and legs.

The fetus is already "ripe", but for the mother's body it takes a few more days to be able to practice (and at the first pregnancy one can even say to learn) to help the child get outside, pushing it through the birth canal with the help of muscle contractions (the same spasms of different intensity, which just cause pain).

Chaotically repeated training bouts with their pulling pains in the lower abdomen and a looseness in the lower back are nothing more than ordinary fights of low intensity. So to say warm-up.

To the appearance of the baby are prepared and the mammary glands of the pregnant woman, who in the last weeks begin to actively produce milk for feeding the baby. All these are physiologically conditioned processes inherent in nature itself.

The pathogenesis of abdominal pain, not related to the preparation for labor, depends on the pathology that causes such feelings. For example, pains that extend to the lower abdomen and the kidney area are caused by a heavy load on the excretory organs of the pregnant woman, who may no longer be able to cope with their duties.

And the development of a pathology such as syphysitis can be associated with a deficiency of calcium in the body of a woman, which causes the weakness of bones and cartilaginous tissue, as well as hormonal changes characteristic of the period of pregnancy, due to which the bone tissue softens a little, making it easier for the baby "way to freedom" .

[2], [3],

Complications and consequences

The consequences of the pulling pains in the lower abdomen, accompanied by all signs of the approach of delivery, will only be the genera themselves that will come in due time (or maybe a little earlier or later). In any case, this is not a cause for concern.

Another thing is if the lower abdomen on the 39th week of pregnancy is pulled due to the development of some pathology that can lead to unpleasant, and often even tragic consequences. Such pathologies are considered to be complications of pregnancy, since they can adversely affect both its course and the health of the mother or child.

For example, kidney pathologies leading to a serious disruption of functions can lead to dangerous intoxication of the mother and fetus, which can even lead to death. Then doctors already have to choose, saving someone.

The detachment of the placenta is considered to be one of the most dangerous pathologies of pregnancy for a child arising at a later date. The severity of the condition depends on the area of the exfoliated "child's place." With detachment of 25-30% of the placenta area, the baby develops severe hypoxia, which will subsequently affect its development (this applies to the physical and especially mental development of the child after it comes into the world). If the placenta exfoliates half, the child faces death in the womb. And for the mother, this can be threatened even by an operation to remove the uterus due to the formation of a retropacental hematoma.

But such a pathology as the syphysite, when everything also pulls the lower abdomen at the 39th week of pregnancy (and sometimes even in the 2nd trimester), is dangerous already for the mother herself. If you do not prevent a strong divergence of the pannus before or during labor, this threatens the woman with a very long and painful rehabilitation period. Very often in this situation, doctors resort to Caesarean section.

Poisonings and constipation become the main cause of intoxication of the organism of the future mother (and hence the fetus in her womb, with which they are linked together all 9 months), and sometimes can cause premature birth.

Infections of the genital tract, if you do not take all the measures to cure before the birth of a child, will most likely pass to the baby while passing through the birth canal. And then everything depends on the type of infection and the consequences caused by it.

Inflammatory diseases of the internal organs of a woman also sometimes cause intrauterine infection of the fetus, which leads to congenital pneumonia, heart disease and other pathologies. For a woman, such a state is dangerous by the development of chorioamniotitis (infection of amniotic membranes and fluid), which after the delivery can go to endometritis (inflammation of the inner layer of the uterus).

[4], [5]

Diagnostics of the stretching pain in the abdomen at 39 weeks gestation

Diagnosis of various conditions during pregnancy is complicated by the fact that not all methods of research in this position are permissible. And the doctor's task is reduced to the selection of methods by which he can accurately diagnose (and on its correctness, the life of the mother and child depends at times), without harming the growing fetus within the woman.

The safest method of differential diagnosis in this case is to collect an anamnesis on the basis of studying the patient's card and her complaints. The questionnaire of the patient should consist of clarification of the gestational age, the nature of the pain and their localization, the accompanying symptoms, the connection of pain with exercise, etc.

Supplementing information, as well as confirming or refuting the suspicion of diseases of the digestive system, kidneys and urinary tract, as well as any inflammatory processes will help analysis (general blood test, general urine analysis, urine analysis by Nechiporenko, etc.).

If a bacteriological or fungal infection of the genital tract is suspected, a swab is taken from the vagina.

As for the biopsy with suspicion of oncology, if the stomach is pulled at 39 weeks of gestation due to the presence of a small pelvic tumor, then such a study is likely to have to be postponed until the baby is born. In extreme cases, you will have to give birth 15, -2 weeks before the expected end of pregnancy.

If the patient's condition indicates a detachment of the placenta, a vaginal examination is mandatory, which can also be performed using instrumental methods (vaginal ultrasound), although this procedure is rarely performed.

Among other methods of instrumental diagnosis during pregnancy (especially in later periods) preference is given to the old good ultrasound, which makes it possible to assess the condition of the placenta and fetus within it, and also to diagnose neoplasms and other diseases of the genitourinary and partially digestive system.

At 38-40 weeks of gestation in the evaluation of the fetal and uterus conditions, such method of instrumental research as cardiotocography comes to the fore. Since the cause of the pulling pains in the lower abdomen during pregnancy becomes an increased tone of the uterus, as indicated by the hardened abdomen, doctors can determine with great accuracy how soon delivery can take place, by measuring the parameters of the tone of the uterus.

The condition of the placenta and its functionality can be judged from the results of dopplerography, which is also not contraindicated in the last weeks of pregnancy.

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Treatment of the stretching pain in the abdomen at 39 weeks gestation

Treatment of pulling sensations in the abdomen at 39 weeks of gestation is carried out only after a comprehensive examination of the future mother, clarifying the symptoms and the cause of the pain. And the approach here needs a special one, since not all forms of drugs effective in the 1st and 2nd trimester of pregnancy are permissible for later use. In particular, the use of vaginal suppositories in the last months of pregnancy is considered undesirable and even dangerous.

If the vomiting of pains in the abdomen becomes the increased tone of the uterus, but in the opinion of the doctors, it is necessary to wait, to relax the muscles of an important female organ, within which the maturation of a new life occurs, you can use special medications that can be used during the last period of pregnancy .

Usually, these are relatively safe antispasmodics, such as No-shpa, Drotaverin, Papaverin and drugs that reduce uterine activity (magnesium preparations: Magne-B-6 complex, magnesium sulfate solution). Rarely in later terms, prescribe such serious medications as "Ginipral", "Bricanil", etc., since subsequently they can adversely affect the course of childbirth.

"Drotaverin" - antispasmodic, effective to prevent early onset of labor. It will help how to reduce the tone of the uterus and reduce pain.

The drug can be administered in the form of tablets or injectively. Single dose is 1-2 tablets or 2-4 ml (40-80 mg). Tablets are taken orally, injections - intramuscularly from 1 to 3 times a day.

Side effects of the drug, which, incidentally, very little, make themselves felt infrequently. Sometimes there may be nausea, headaches, dizziness, allergic manifestations (swelling and rashes on the skin). Occasionally, doctors diagnose a decrease in blood pressure and pulse, sleep disorders, constipation.

Contraindications to the use of the drug are severe liver and kidney damage, heart failure, hypersensitivity to any of the components of the drug. Do not take the drug and during breastfeeding.

Magnesium sulfate solution (magnesia) is a favorite in gynecology and obstetrics medicine used for various periods of pregnancy to prevent miscarriage and premature birth.

The dosage of the drug is highly individual. Enter the drug intramuscularly and intravenously (slow injection or as a dropper).

During therapy with the drug, the following side effects can occur: lowering blood pressure, increasing the frequency and strength of the heart, feeling hot, shortness of breath, headaches, fainting, confusion, speech disorders, numbness or trembling in the limbs. Sometimes there are reactions from the gastrointestinal tract in the form of nausea and vomiting, allergic manifestations, skin reactions, metabolic disorders and other unpleasant symptoms.

The drug is not used if a patient with complaints that pulls and aches a lower abdomen on 39 weeks of pregnancy, there are the following pathologies: severe disruption of the kidney and / or liver, myasthenia gravis, malignant tumors. Stably low blood pressure, a bradycardia with a pulse rate below 55 beats per minute, hypersensitivity to components, conditions due to calcium deficiency and some others are also contraindications to the use of the drug.

If the pulling pains in the lower abdomen are associated with impaired intestinal activity (constipation), Dufalac, which is safe for the mother and fetus, is produced in vials in the form of syrup or in bags for the preparation of a medicinal solution.

Dosage and frequency of the drug during pregnancy is established by the doctor individually in each case, based on the patient's condition and the results of the gynecological examination.

Taking the drug in large doses can cause flatulence, diarrhea, nausea (sometimes vomiting), pain in the abdomen.

Contraindications to the drug are: a violation of the metabolism of galactose, gastrointestinal obstruction, perforation of the gastrointestinal tract, as well as hypersensitivity to various components of the drug.

If a bacterial, viral or fungal infection has been detected in the body of a woman, the therapy will have to be carried out with antibacterial drugs (during pregnancy, erythromycin, cephalosporins and drugs from the group of unprotected aminopenicillins are permissible). The choice of drugs is carried out only by a specialist doctor, taking into account the condition of the woman.

If there are inflammatory diseases of the kidneys and urinary tract, antibiotic treatment is preceded by a therapy aimed at improving the outflow of urine (diuretics and diuretics).

Vitamins are shown to a pregnant woman throughout the pregnancy and even after childbirth. Usually, when they are appointed, doctors prefer vitamin-mineral complexes that promote the maintenance of the mother's health and the full development of the fetus.

The optimal option, if pulling the abdomen in the 39th week of pregnancy, will be taking the drug "Magnesium B6", which effectively fights and with spasms of the smooth muscles of the uterus, and with increased nervousness of the woman on the eve of childbirth.

The recommended daily dosage is from 6 to 8 tablets. This dose should be divided 2-3 times. Use tablets during meals.

Side effects of the drug very little. Sometimes there are allergic reactions, as well as various violations of the digestive system.

Do not apply the vitamin-mineral complex in case of severe kidney damage, impaired metabolism of phenylalanine, fructose intolerance and other components of the drug, a deficiency of sucrose-isomaltase, a syndrome of glucose-galactose malabsorption.

On the possibility of physiotherapeutic treatment of pulling pains in the lower abdomen in late pregnancy in connection with the development of certain pathologies should consult with the attending physician. As well as about any thermal, and also other medical procedures for removal of spasms, which some women try to practice at home.

Alternative treatment of traumatic pains in the lower abdomen

Alternative treatment of pain in the abdomen is also carried out based on the diagnosis. Its effectiveness is proved, if such treatment is used in parallel with traditional medicamentous.

Although if the abdomen is pulled at the 39th week of pregnancy due to fetal pressure, and the pains appear as a prenatal exercise, you can confine yourself to alternative medicine advice as a monotherapy to alleviate the condition. But again, without consulting a doctor, the use of any alternative means is not recommended, if there is a desire to give birth to a healthy child in due time.

To slightly reduce the tone of the uterus, alternative medicine recommends including in your diet foods rich in magnesium: nuts, especially hazelnuts and almonds, cereals (oat and buckwheat), legumes (beans), any green vegetables.

A special relaxation technique will help also, based on the fact that if you relax your facial muscles, there is an automatic relaxation of the uterine musculature. It is enough to sit down in a comfortable position, try to relax the muscles of the face and neck as much as possible and breathe evenly. Spasm and pain go away within a couple of minutes.

In this situation, treatment with herbs will help. Calendula, yarrow, valerian, motherwort, sage and St. John's wort will help to relax the muscles of the uterus, will prevent bleeding and will promote better access of oxygen and nutrients to the fetus by improving blood circulation. But chamomile, nettle, dill, hay, aloe and some other herbs may on the contrary cause premature birth.

To fight with constipation and associated aching pain in the abdomen will help proper nutrition: a glass of pure water on an empty stomach plus a vitamin mix (dried apricots, prunes, raisins) plus foods rich in fiber (cereals, greens, vegetables and fruits).

With pyelonephritis, pumpkin, from which it is possible to cook a variety of dishes, and watermelon (instead of water or as a dessert with a black bread), will be useful. These vegetables have an excellent anti-inflammatory and diuretic effect, which is very important in the fight against inflammation of the urinary system. Of the herbs, the horsetail and the bear ears are useful and safe.

Treatment of sexual infections by alternative means by douching during pregnancy is not applied, and other methods of alternative treatment in this case are unlikely to be effective.

[7], [8]

Homeopathy in Pregnancy

It's no secret that preparations of homeopathy with a minimum of side effects and contraindications can serve women well in anticipation of the baby. But also to their reception it is necessary to be treated with great care, even in the last weeks of pregnancy, when the birth can not be called premature in the full sense of the word.

If it makes sense to take homeopathic remedies, if the lower abdomen pulls on the 39th week of pregnancy, it should be decided not by the woman herself, but by her attending physician. Perhaps in this situation it will be preferable to begin the delivery a little earlier than to remove spasms caused by normal physiological processes.

Yes, muscle cramps in the uterus, typical for training bouts, you can try to remove using homeopathic remedies Agarikum or Spaskuprel. The latter is considered more preferable for the removal of spasms in the uterus. Take it you need 1 tablet 3 times a day after eating. Tablets should be kept in your mouth until dissolved.

With constipation in the last period of pregnancy, Aluminum (aluminum oxide), Collinsonia and Opium will be useful. Dosage and frequency of taking these drugs, safe for a pregnant woman and her baby, it is necessary to clarify the doctor-homeopath.

Urinary and genital tract infections can be treated with Cantaris and Dulcamara. But again after consulting with the attending physician in the question of the appropriateness and safety of such therapy.

Operative treatment

Since the 39th week is considered a period of full term pregnancy, when all the fetal systems are already fully formed, any abnormalities during this time can become indications for urgent delivery or surgical treatment (caesarean section).

If the abdomen is pulled at the 39th week of pregnancy and all signs indicate that real labor has begun (the force of spasms is increasing and the time interval between them is gradually decreasing, possibly the passage of amniotic fluid), the doctor decides on the optimal variant of labor based on the state of health and constitutional features of the pregnant patient.

Indications for caesarean section may be: narrow pelvis, high probability of myopia (bleeding in the eye) under tension, transverse position of the fetus, rapid irreversible cessation of labor, threat of rupture of the old cicatrix (with repeated operation of cesarean section), prolapse of the umbilical cord, symphysitis.

If there is an abruption of the placenta, the caesarean section is inevitable, and in the shortest possible time.

Sometimes cesarean section doctors resort to avoid complications, if the mother has severe pathologies of the cardiovascular system and kidneys. And also to prevent infection of the baby while passing through the birth canal in case the mother is diagnosed with untreated sexual infections. There is already a decision on the operation remains for the doctor.

Prevention

If we talk about the prevention of pulling pains in the lower abdomen in the last period of pregnancy, the main measure can be considered the intake of magnesium preparations that help to eliminate the deficit of this microelement during the entire pregnancy and before childbirth. After all, magnesium prevents the increase of the tone of the uterus, relaxing muscle muscles, and also facilitates the course of childbirth.

An important role in the processes occurring at the finish of pregnancy, and plays a woman's nutrition, which should be full, rich in vitamins and trace elements.

Nutrition, of course, is important, but also for the health of your woman should follow as carefully as possible, passing preventive examinations and referring to the doctor for any disturbing it. It is impossible to allow during the entire period of pregnancy to enter the organism of the future mummy of various infections, including respiratory infections. After all, infections of any type are dangerous both for the unformed baby and for the child, who is ready to see the light, but still in the womb. On this depends and the health of the baby after his birth.

Proper nutrition, a healthy lifestyle, avoidance of hypodynamia (if possible) will help to establish and work of the gastrointestinal tract. So the woman will not be tormented by constipation, threatening to develop into hemorrhoids.

The use of foods rich in calcium, and special vitamin-mineral complexes for pregnant women, according to the doctor's indications, will reduce the likelihood of developing symphysitis. If the disease makes itself felt, then to prevent complications the pregnant woman will have to limit herself in movement, wear a "bandage", perform special exercises, take anti-inflammatory and vitamin-mineral complexes and follow other doctor's instructions.

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Forecast

The prognosis of the pulling pains in the lower abdomen depends on the cause that caused such sensations, and the therapeutic measures to eliminate this cause. The best prognosis, of course, is observed in pregnant women, whose body thus informs a woman about the approach of delivery. The worst prognosis with a significant delamination of the placenta, when the account goes literally for a second.

Pulls the stomach at 39 weeks gestation, and there are other unusual symptoms? This is an occasion to visit the doctor as soon as possible and tell us about your anxiety and fears. Perhaps these experiences are groundless, and you will soon become the happiest mother in the world. But sometimes this foresight helps to avoid very sad consequences. But there is nothing more terrible for the mother than the disability or even the death of the long-awaited child, in which the mother will only blame herself for her own carelessness.

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