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

Pregnancy is a special time in the life of every woman. It is the happiness that overwhelms the future mother just from the thought that a new life is growing inside her, so warm and dear, even if the baby does not yet realize it. On the other hand, it is almost 40 weeks of worries and concerns for the life of the unborn baby. And it is not at all surprising when a pregnant woman experiences the situation so acutely when she feels a pulling pain in the lower abdomen at 39 weeks of pregnancy. What is this: an alarm signal or is her baby simply in a hurry to see the light, not wanting to wait another minute?

Causes 39 weeks pregnant with a pulling pain in the lower abdomen

Since childbirth in the penultimate week of pregnancy is considered a normal variant, many "good" people advise not to worry too much, but to prepare for the imminent birth of the baby. In most cases, this advice will be beneficial, calming the already tense nerves of a pregnant woman in the prenatal period. But sometimes, a seemingly correct wish can play a cruel joke.

The thing is that the causes of nagging pain in the lower abdomen at 39 weeks of pregnancy can be different, and they do not always indicate an approaching meeting with the baby that has been born. Here you need to pay attention not only to the aching pain, which many compare with the pain of menstruation, but also to the accompanying symptoms. But they can often tell you much more about what is actually happening than the pain itself.

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

• The woman periodically feels a nagging pain in the pelvic area, which is often accompanied by unusual pressure from the inside on the area of the ureter and external genitalia.
• The belly drops (of course, this can happen a couple of weeks earlier) and becomes harder.
• Periodically appearing pulling pains, accompanied by dull, aching pains in the lower back, may indicate the onset of false contractions, which are also called training or Breast-Higgs contractions, or be caused by increasing pressure of the fetus on the mother's pelvic floor towards the end of pregnancy.
• Strong abdominal pressure on the pelvic organs causes loose stools and more frequent urination, while the amount of urine excreted decreases. Sometimes nausea occurs, which is not related to food intake, but to the position of the uterus before childbirth.
• During this same period, a woman may observe the passage of the “plug” (thick transparent mucus with or without blood inclusions), which protects the birth canal from infection that is dangerous for the fetus.
• The weight of the mother in labor may decrease by 0.5-1 kg.
• The baby becomes less active and makes itself known no more than 10-12 times a day.
• The cervix begins to prepare for childbirth (opens slightly).

If a woman feels a pulling sensation in her lower abdomen at 39 weeks of pregnancy and notices other symptoms that are harbingers of imminent labor, there is no need to be alarmed. It is better to check whether everything is ready for the appearance of a new tenant in the house. But you should not move actively during this period, so as not to rush things. Let everything take its course.

Unfortunately, not always pulling pains in the lower abdomen are the first signs of approaching labor. Sometimes such sensations are associated with pathological processes in the woman's body, which are dangerous both for her and for her unborn baby.

Aching pain and heaviness in the abdomen can be a sign of digestive problems, and if such pain intensifies, adding belching of rotten eggs, nausea, vomiting, diarrhea, this indicates poisoning, which is possible at any stage of pregnancy, but is especially dangerous in the last days.

If aching pains are accompanied by vaginal discharge that has a strange color or smell, contains a large amount of blood or pus, this is a signal that something is wrong in the woman's body. For example, saturated bloody discharge may indicate the onset of bleeding, the causes of which can be many. Probably the most terrible of them during this period is placental abruption. And disruption of the placenta, which ensures 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 may be various cardiovascular and endocrine diseases, kidney and liver dysfunction, toxicosis of pregnancy, inflammatory processes in the uterus and the placenta itself. There are also some risk factors indicating the possibility of placental abruption: late childbirth, a large number of births, pregnancy after long-term treatment for infertility, bad habits (smoking, drinking alcohol, poor nutrition), allergies to medications, abdominal trauma, heavy physical exertion, predisposition (according to anamnesis). If blood-saturated discharge appears, it is imperative to call an ambulance and go to the maternity hospital.

Small white discharge will most likely indicate a fungal infection (thrush), while purulent discharge with a smell - a sexually transmitted bacterial infection. In any case, this is a reason to immediately visit your gynecologist to prevent various complications.

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

The causes of aching and pulling pain in the lower abdomen both at 39 weeks of pregnancy and at other times can be various benign and malignant neoplasms (polyps, fibroids, tumors).

If mild pain in the pelvic area is accompanied by lower back pain, this state of affairs may equally indicate the body's preparation for childbirth (practice contractions), and kidney disease due to hypothermia or increased stress on them during pregnancy, because the kidneys have to work for two.

Pain in the lower abdomen can also be a symptom of inflammatory diseases of the pelvic organs, as well as such a pathology of pregnant women as symphysitis (excessive mobility of the pubic symphysis, which is caused by the body's preparation for childbirth), which is dangerous for the mother herself, although it has no effect on the health of the baby.

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Pathogenesis

Epidemiological studies show that in most cases pregnant women experience lower abdominal pain at 39 weeks of pregnancy due to the approach of labor. Why does this happen?

There is nothing surprising about this, because in our rational world there is no place for coincidences. If a woman's body has been preparing for an important event for 38-39 weeks, then why shouldn't it have a dress rehearsal in the last weeks?! And the baby is already quite ready to come into our world, since all of its vital organs and systems are sufficiently formed. In the mother's womb, there is already little space for it even for normal life activities, let alone active movements of arms and legs.

The fetus is already “ripe,” but the mother’s body needs a few more days to train (and in the case of a first pregnancy, you can even say learn) to help the baby get out, pushing it along the birth canal with the help of muscle contractions (the same spasms of varying intensity that cause pain).

Chaotically recurring training contractions with their nagging pains in the lower abdomen and aching in the lower back are nothing more than ordinary contractions of low intensity. A warm-up, so to speak.

The mammary glands of a pregnant woman are also preparing for the arrival of the baby, and in the last weeks they begin to actively produce milk to feed the child. All these are physiologically determined processes, laid down by nature itself.

The pathogenesis of lower abdominal pain not associated with preparation for labor depends on the pathology that causes such sensations. For example, pain that spreads to the lower abdomen and kidney area is caused by a large load on the excretory organs of a pregnant woman, which may no longer be able to cope with their duties.

And the development of such a pathology as syphysitis can be associated with both a calcium deficiency in the woman’s body, which causes weakness of the bones and cartilage tissue, and hormonal changes characteristic of the pregnancy period, as a result of which the bone tissue softens a little, facilitating the baby’s “path to freedom”.

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Complications and consequences

The consequences of nagging pains in the lower abdomen, accompanied by all the signs of approaching labor, will only be the labor itself, which will occur at the appointed time (and maybe even a little earlier or later). In any case, this is not a reason to worry.

It is another matter if the lower abdomen at 39 weeks of pregnancy is pulling due to the development of some pathology that can lead to unpleasant, and often even tragic consequences. Such pathologies are considered complications of pregnancy, since they can negatively affect both its course and the health of the mother or child.

For example, kidney pathologies that lead to serious disruption of their functions can lead to dangerous intoxication of the mother and fetus, which can even lead to death. Then doctors have to choose, saving one of them.

Placental abruption is considered one of the most dangerous pregnancy pathologies for the child, occurring in the late stages. The severity of the condition depends on the area of the detached "baby's place". If 25-30% of the placenta area detaches, the baby develops severe hypoxia, which will subsequently affect its development (this applies to both the physical and especially the mental development of the child after its birth). If the placenta detaches halfway, the child is at risk of death in the womb. And for the mother, this may even threaten an operation to remove the uterus due to the formation of a retroplacental hematoma.

But such a pathology as syphysitis, when the lower abdomen still pulls at 39 weeks of pregnancy (and sometimes even in the 2nd trimester), is dangerous for the mother herself. If a strong divergence of the pubic symphysis is not prevented before or during childbirth, this threatens the woman with a very long and painful rehabilitation period. Very often in such a situation, doctors resort to a cesarean section.

Poisoning and constipation become the main cause of intoxication of the body of the expectant mother (and therefore the fetus in her womb, with whom they are connected together for all 9 months), and sometimes can cause premature birth.

Genital tract infections, if not treated before the birth of the child, are likely to be transmitted to the baby during passage through the birth canal. And then everything depends on the type of infection and the consequences it causes.

Inflammatory diseases of the internal organs of a woman also sometimes cause intrauterine infection of the fetus, which leads to congenital pneumonia, heart defects and other pathologies. For a woman, this condition is dangerous due to the development of chorioamniotitis (infection of the amniotic membranes and fluid), which after delivery can develop into endometritis (inflammation of the inner layer of the uterus).

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Diagnostics 39 weeks pregnant with a pulling pain in the lower abdomen

Diagnosis of various conditions during pregnancy is complicated by the fact that not all research methods are permissible in this situation. And the doctor's task is to select methods with which he can accurately make a diagnosis (and the life of the mother and child sometimes depends on its correctness), without causing harm to the fetus growing inside the woman.

The safest method of differential diagnostics in this case is to collect anamnesis based on the study of the patient's chart and her complaints. The patient's survey should include clarification of the pregnancy period, the nature of pain and its localization, accompanying symptoms, the relationship of pain with physical activity, etc.

To supplement the information, as well as confirm or refute the suspicion of diseases of the digestive system, kidneys and urinary tract, as well as any inflammatory processes, tests (general blood test, general urine test, urine test according to Nechiporenko, etc.) will help.

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

As for a biopsy in case of suspected oncology, if the stomach is pulling at 39 weeks of pregnancy due to the presence of a tumor process in the pelvic area, then such a study will most likely 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 the pregnancy.

If the patient's condition indicates placental abruption, a vaginal examination is mandatory, which, if indicated, can also be performed using instrumental methods (vaginal ultrasound), although such a procedure is rarely performed.

Among other methods of instrumental diagnostics during pregnancy (especially in the later stages), preference is given to the good old ultrasound, which makes it possible to assess the condition of the placenta and the fetus inside it, as well as to diagnose neoplasms and other diseases of the genitourinary and partially digestive systems.

At 38-40 weeks of pregnancy, such an instrumental examination method as cardiotocography comes to the forefront in assessing the condition of the fetus and uterus. Since the cause of nagging pain in the lower abdomen during pregnancy is the increased tone of the uterus, as indicated by a hardened abdomen, doctors can determine with great accuracy how soon labor may occur by measuring the tone of the uterus.

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

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Treatment 39 weeks pregnant with a pulling pain in the lower abdomen

Treatment of pulling sensations in the lower abdomen at 39 weeks of pregnancy is carried out only after a comprehensive examination of the expectant mother, identification of the symptoms and cause of pain. And a special approach is needed here, since not all forms of drugs that are effective in the 1st and 2nd trimesters of pregnancy are allowed for use in the later stages. In particular, the use of vaginal suppositories in the last months of pregnancy is considered undesirable and even dangerous.

If the reason for the nagging pain in the abdomen is increased uterine tone, but in the opinion of doctors, childbirth should still be postponed, special drugs that are approved for use in the last stages of pregnancy can be used to relax the muscles of the important female organ, inside which the maturation of a new life occurs.

Usually these are relatively safe antispasmodics such as No-shpa, Drotaverine, Papaverine and drugs that reduce uterine activity (magnesium preparations: Magne B-6 complex, magnesium sulfate solution). Rarely in the later stages are such serious drugs prescribed as Ginipral, Brikanil, etc., since they can subsequently have a negative impact on the course of labor.

"Drotaverine" is an antispasmodic, effective in preventing early onset of labor. It will help to reduce the tone of the uterus and reduce pain.

The drug can be prescribed both in tablet and injection form. A single dose is 1-2 tablets or 2-4 ml (40-80 mg). Tablets are taken orally, injections are intramuscularly from 1 to 3 times a day.

The drug's side effects, which, by the way, are very few, rarely make themselves known. Sometimes nausea, headaches, dizziness, allergic reactions (swelling and skin rashes) may be observed. Occasionally, doctors diagnose decreased 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. The drug is also not taken during breastfeeding.

Magnesium sulfate solution (magnesia) is a favorite drug in gynecology and obstetrics, used at various stages of pregnancy to prevent miscarriage and premature birth.

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

During therapy with the drug, the following side effects may be observed: decreased blood pressure, increased heart rate and strength, feeling of heat, shortness of breath, headaches, fainting, confusion, speech disorders, numbness or tremors in the limbs. Sometimes there are reactions from the gastrointestinal tract in the form of nausea and vomiting, allergic reactions, skin reactions, metabolic disorders and other unpleasant symptoms.

The drug is not used if the patient with complaints of pulling and aching in the lower abdomen at 39 weeks of pregnancy has the following pathologies: severe kidney and/or liver dysfunction, myasthenia, malignant tumors. Stably low blood pressure, bradycardia with a pulse rate below 55 beats per minute, hypersensitivity to the components, conditions caused by calcium deficiency and some others are also contraindications to the use of the drug.

If nagging pain in the lower abdomen is associated with intestinal dysfunction (constipation), the drug "Dufalac" will be effective. It is safe for the mother and fetus and is available in bottles as a syrup or in sachets for preparing a medicinal solution.

The dosage and frequency of taking the drug during pregnancy is determined by the doctor individually in each specific 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), and abdominal pain.

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

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

If there are inflammatory diseases of the kidneys and urinary tract, antibiotics are preceded by therapy aimed at improving urine flow (diuretics and diuretics).

Vitamins are recommended for pregnant women throughout the entire pregnancy and even after childbirth. Usually, when prescribing them, doctors give preference to vitamin and mineral complexes that help maintain the health of the mother and the full development of the fetus.

The best option if you have a pulling pain in your lower abdomen at 39 weeks of pregnancy is to take the drug "Magnesium B6", which effectively combats both spasms of the smooth muscles of the uterus and increased nervousness of a woman on the eve of childbirth.

The recommended daily dosage is 6 to 8 tablets. This dose should be divided into 2-3 times. Tablets are taken during meals.

The drug has very few side effects. Sometimes allergic reactions occur, as well as various digestive system disorders.

The vitamin-mineral complex should not be used in cases of severe kidney damage, phenylalanine metabolism disorders, intolerance to fructose and other components of the drug, sucrase-isomaltase deficiency, or glucose-galactose malabsorption syndrome.

It is worth consulting with your doctor about the possibility of physiotherapeutic treatment of nagging pain in the lower abdomen in late pregnancy due to the development of certain pathologies. As well as about any thermal and other therapeutic procedures to relieve spasms, which some women try to practice at home.

Folk remedies for pulling pains in the lower abdomen

Traditional treatment of abdominal pain is also carried out based on the diagnosis. Its effectiveness has been proven if such treatment is used in parallel with traditional medication.

Although if the lower abdomen is pulling at 39 weeks of pregnancy due to pressure from the fetus, and the pain appears as a prenatal training, you can limit yourself to the advice of traditional medicine as a monotherapy to alleviate the condition. But again, without consulting your doctor, the use of any folk remedies is not recommended if you want to give birth to a healthy child on time.

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

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

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

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

Pumpkin, from which you can prepare various dishes, and watermelon (instead of water or as a dessert with black bread) will be useful for pyelonephritis. These vegetables have an excellent anti-inflammatory and diuretic effect, which is very important in the fight against inflammation of the urinary system. Horsetail and bear's ears will be useful and safe among herbs.

Treatment of sexually transmitted infections with folk remedies by douching during pregnancy is not used, and other folk treatment methods are unlikely to be effective in this case.

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Homeopathy during pregnancy

It is no secret that homeopathic medicines with a minimum of side effects and contraindications can be of great service to women expecting a baby. But their use should be treated with great caution, even in the last weeks of pregnancy, when the birth can no longer be called premature in the full sense of the word.

Whether it makes sense to take homeopathic medicines if the lower abdomen is pulling at 39 weeks of pregnancy should be decided not by the woman herself, but by her attending physician. Perhaps in this situation it would be preferable to begin labor a little earlier than to relieve spasms caused by normal physiological processes.

Yes, muscle spasms in the uterine area, typical of training contractions, can be tried to relieve with the help of homeopathic remedies Agaricum or Spascuprel. The latter is considered more preferable for relieving spasms in the uterus. It should be taken 1 tablet 3 times a day after meals. The tablets should be kept in the mouth until completely dissolved.

For constipation in the last stages of pregnancy, the following drugs will be useful: Alumina (aluminum oxide), Collinsonia and Opium. The dosage and frequency of taking these drugs, which are safe for the pregnant woman and her baby, must be clarified with a homeopathic doctor.

Urinary and genital tract infections can be treated with Cantharis and Dulcamara. But again, after consulting with your doctor about the appropriateness and safety of such therapy.

Surgical treatment

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

If the lower abdomen is pulling at 39 weeks of pregnancy and all signs indicate that real contractions have begun (the strength of the spasms is increasing, and the time interval between them is gradually decreasing, the amniotic fluid may be released), the doctor decides on the best option for childbirth, based on the health and constitutional characteristics of the pregnant patient.

Indications for a caesarean section may include: a narrow pelvis, a high probability of myopia (bleeding into the eye) during straining, transverse fetal position, rapid irreversible cessation of labor, the threat of rupture of an old scar (during a repeat caesarean section), prolapse of the umbilical cord, symphysitis.

If placental abruption is observed, then a caesarean section is inevitable, and in the shortest possible time.

Sometimes doctors resort to a cesarean section to avoid complications if the mother has pronounced pathologies of the cardiovascular system and kidneys. And also to prevent the baby from becoming infected during passage through the birth canal if the mother has been diagnosed with untreated sexually transmitted infections. In this case, the decision about the operation remains with the doctor.

Prevention

If we talk about the prevention of nagging pains in the lower abdomen in the last stages of pregnancy, the main measure can be considered the intake of magnesium preparations, which help to eliminate the deficiency of this microelement throughout the pregnancy and before childbirth. After all, it is magnesium that prevents the increase in the tone of the uterus, relaxing the muscular musculature, and also facilitates the course of childbirth.

A woman’s nutrition, which should be complete and rich in vitamins and microelements, also plays an important role in the processes that occur at the end of pregnancy.

Nutrition is, of course, important, but a woman should also monitor her health more carefully than ever, undergoing preventive examinations and contacting a doctor for any reason that worries her. During the entire period of pregnancy, various infections, including respiratory ones, should not be allowed to enter the body of the expectant mother. After all, infections of any type are dangerous both for the baby that has not yet formed, and for the child who is quite ready to see the light, but is still in the womb. The health of the baby after birth also depends on this.

Proper nutrition, a healthy lifestyle, and avoiding physical inactivity (if possible) will help to improve the functioning of the gastrointestinal tract. This means that a woman will not be tormented by constipation, which threatens to develop into hemorrhoids.

Consuming calcium-rich foods and special vitamin-mineral complexes for pregnant women as prescribed by a doctor will reduce the likelihood of developing symphysitis. If the disease makes itself known, then to prevent complications, the pregnant woman will have to limit her movement, wear a "bandage", do special exercises, take anti-inflammatory and vitamin-mineral complexes and follow other doctor's instructions.

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Forecast

The prognosis for nagging pain in the lower abdomen depends on the cause of such sensations and the treatment measures to eliminate this cause. The best prognosis, of course, is observed in pregnant women, whose body thus informs the woman about the approach of labor. The worst prognosis is with significant placental abruption, when every second counts.

Is your stomach hurting at 39 weeks of pregnancy, and are there other unusual symptoms? This is a reason to visit a doctor as soon as possible and tell about your concerns and fears. Perhaps these worries are groundless, and you will soon become the happiest mother in the world. But sometimes such foresight helps to avoid very sad consequences. But there is nothing worse for a mother than disability or even the death of a long-awaited baby, for which the mother will have to blame only herself for her own carelessness.

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