Why pulls the lower abdomen at 4 weeks of pregnancy and what to do?

Pregnancy is undoubtedly one of the most important stages in a woman's life. It is an exciting and wonderful period, which at the same time is not without worries and concerns. Any pregnancy is accompanied by a change in sensations. New sensations appear that were not observed before. Sometimes such sensations can cause anxiety in a woman, especially if this is her first pregnancy.

Most women start to worry when they have a pulling pain in the lower abdomen in the 4th week of pregnancy. Women start to worry because they do not know why these pains occur, what they are associated with, whether they are dangerous. The situation is complicated by the fact that in the 4th week a woman may not even know about the pregnancy. Therefore, many are confused and start to panic. In order to take the right actions, it is necessary to know the reasons for which these pains occur.

Causes lower abdominal pulling sensations at 4 weeks' gestation

In the early stages of pregnancy, there may be nagging pains in the lower abdomen. They may be physiological or pathological. If the pains are physiological, they are a consequence of natural processes that occur in the body. There is no need to worry about such pains. They help the body successfully adapt to new conditions, to bearing a child, and usually disappear after a few months without any treatment.

If the pain is pathological, you should see a doctor immediately. Pathological pain usually requires urgent measures and can be dangerous to health and life.

Physiological pain usually occurs as a result of the body's adaptation to new conditions. The body is preparing to bear a fetus. Various processes occur in the uterus, it is activated, grows. The uterine ligaments that support the uterus are stretched. In some cases, the uterus may experience excessive contraction, be in too intense tone. See the publication Increased tone of the uterus during pregnancy.

The painful sensations may be caused by the process of implantation of the egg into the uterine mucosa. Painful sensations also arise as a result of the uterus contracting too often or growing intensively. Usually, the growing uterus presses on the surrounding organs, blood vessels and nerves. Such contractions may be facilitated by intense strain, nervous stress, mental trauma, fatigue, nervous tension. Frequent colds may also cause the uterus to become overactive.

If the uterus contracts constantly and too strongly, hypertonicity may occur. It is also accompanied by painful sensations. It is felt as a compaction, compression in the lower abdomen. Usually, at such early stages, the uterus is not yet palpable. The cause of such hypertonicity can be, first of all, excessive nervousness, anxiety, excitement. Hypertonicity can also be a physiological stress: it occurs when wearing uncomfortable shoes, in an uncomfortable position, pose, with restrictive clothing. Even frequent colds, muscle strain can cause hypertonicity.

The cause of pathological miscarriage may be a beginning miscarriage or spontaneous abortion. Tumors, fibroids, myomas, inflammatory diseases, infections, and even other concomitant diseases often contribute to the occurrence of pathological pain.

Risk factors

The main risk factors that contribute to the occurrence of nagging pain during pregnancy are diseases of the endocrine and nervous systems, metabolic disorders in the body and disruption of the general hormonal background. With reduced immunity, the risk of pain, the presence of concomitant diseases and pathologies increases significantly. Women with their first pregnancy experience such pain more often.

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Pathogenesis

The pain may be related to the process of fertilization. The main period when the probability of fertilization is the highest is the period of ovulation, which occurs approximately 14 days before the onset of menstruation.

Then the fertilized egg gradually moves along the fallopian tubes and enters the uterine cavity. This usually occurs during menstruation. The implantation of the egg into the mucous membrane begins. After the egg has implanted into the mucous membrane, the cell begins to divide, gradually moving deeper into the uterine layers. This process can be painful, and takes an average of 5-7 days.

After implantation, the cell continues to divide, a zygote is formed, then a morula, a blastocyst. As the cell grows, the uterus grows. This process can also be painful. Firstly, growth activation processes occur in the uterus, metabolism increases, and blood filling of the uterus increases. Secondly, muscle fibers and ligaments are stretched.

The uterus increases in size and begins to press on the surrounding organs, blood vessels, nerves. There are painful sensations in those organs that are located nearby.

As the uterus grows, the nearby ligaments, tendons, and muscles that hold the uterus are stretched. The muscles of the pelvic and abdominal region are also stretched. The circular muscles are the first to be stretched.

As the uterus grows, the fibrous fibers begin to stretch. They stretch the slowest, and the process is painful. Hypertonicity of the uterus, in which its muscles and fibers are excessively compressed, can also cause pain.

Contractions of the uterus are generally a natural process, as the uterus is a hollow organ made of muscle tissue. Pain does not occur with normal rhythmic contractions of the uterus. However, if the contractions become too intense, it can cause pain. Usually, such excessive contractions occur as a result of overactivity of the nervous system, when the brain is overstrained and sends an excessive number of nerve impulses.

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Epidemiology

There is implantation bleeding, which occurs during the period when the egg is implanted. It is typical for about 30% of women. If the bleeding is not too intense, there is no need to worry. But if the blood starts to flow uncontrollably, clots appear, this should be a cause for concern. Intense bleeding is also indicated by bright scarlet blood, which is significantly different in color from the color of the blood that is released during normal menstruation.

Implantation bleeding can be difficult to distinguish from menstruation, as it coincides with it in time. Implantation bleeding can end in miscarriage or spontaneous abortion. Thus, a woman may not even know that she is pregnant. This is how about 70% of pregnancies end.

According to statistics, in 73% of cases pain is a natural physiological process, in 23% - pathological. Such pain can have serious consequences and often ends in death.

In 8% of cases, the cause of pathological pain is an ectopic pregnancy. In women over 35, it is observed in 54% of cases. In adolescents, ectopic pregnancy occurs in 38% of cases. Maternal mortality in this case is 4% of cases.

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Symptoms

The symptoms are easy to recognize. If it is physiological pain, it passes quickly enough, you just need to change position, relax. Usually the pain is short-lived, lasting up to half an hour. It passes on its own. It does not cause much concern to the woman.

If bloody or other discharge appears, this already indicates pathological pain. With such pain, you should contact a doctor as soon as possible.

It is important to be able to distinguish physiological pain from pathological pain. This makes it possible to take the right measures. Thus, physiological pain is short-term. It can occur after eating, excessive physical exertion. It passes quickly. The main condition under which such pain disappears is relaxation. The pain passes when changing position, during rest. The pain can pull, tingle, but it is always dull, blurred. It does not cause severe discomfort. Also, with physiological pain there is no bloody discharge. Discharge of a non-bloody nature is also not observed.

If there are discharges from the genital tract, especially bloody ones, relaxation is also not effective, blood clots appear, an unusual odor - this indicates a pathology. blood clots appear, an unusual odor

The first signs are usually a feeling of pressure, tension in the lower abdomen, which does not bother constantly, but episodically. They pass quite quickly.

Diagnostics lower abdominal pulling sensations at 4 weeks' gestation

During diagnostics, first of all, it is determined whether the pain is a consequence of pregnancy or not related to pregnancy. A gynecologist or obstetrician-gynecologist will help to figure this out. The main diagnostic method is the hCG test, which shows the ratio of hormones and can confirm or deny pregnancy.

A gynecological examination and survey are also conducted. During the examination, the doctor takes a smear to determine the microflora and cytology. This makes it possible to imagine the overall picture of what is happening. Atypical cells may be found in the smear, indicating tissue degeneration processes, the likelihood of malignant tumors. It is also possible to detect or exclude dysbacteriosis, an infectious or venereal disease. The smear shows whether there are any inflammations in the reproductive organs that can cause pain. If this is not enough, additional laboratory and instrumental studies should be carried out to help establish the correct diagnosis, determine the cause and take adequate measures. Differential diagnostics are needed to exclude other diseases.

Tests

At 4 weeks of pregnancy, it is still too early to conduct any tests. Many women at this time do not even know about their pregnancy. Pregnancy can be indirectly indicated by a delay in menstruation. Also, after the delay, a blood test for hCG can be done.

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Instrumental diagnostics

An ultrasound can be performed. The embryo cannot be seen yet, but the yolk sac containing the fertilized egg can already be detected. It is clearly visible on the ultrasound and can be traced as a ball 2-3 cm in diameter. Thus, only the presence of the embryonic sac can be confirmed. An abdominal or transvaginal ultrasound is performed. The placenta can now be assessed and its possible pathologies can be identified.

Differential diagnosis

Natural pains must be differentiated from miscarriage, ectopic pregnancy, inflammatory and infectious diseases. Pains are also differentiated from gastrointestinal diseases, since pain irradiation is often observed. It is important to differentiate from acute surgical pathologies, when immediate surgical intervention is required.

For example, a feeling of pressure may indicate a miscarriage, then the pain becomes sharp and acute. It becomes intense, reminiscent of contractions. All this is accompanied by the release of blood from the genitals, a sharp deterioration in general health. In this case, it is necessary to immediately call an ambulance.

An ectopic pregnancy is the second life-threatening condition, in which you should also immediately call an ambulance. With an ectopic pregnancy, there is a sharp pain that is localized on one side of the abdomen, not in the center. The pain is not pulling, but sharp, abrupt, radiating to the leg, groin, hips. The pain increases sharply, the woman may lose consciousness, which usually indicates internal or external bleeding, and may end in death.

The main method of differential diagnostics is hCG analysis and ultrasound examination. Usually, hCG analysis indicates pregnancy, and ultrasound does not detect the fertilized egg.

In inflammatory diseases, nagging pains are accompanied by fever and vaginal discharge. The main diagnostic method is a vaginal smear and ultrasound.

Uterine fibroids can be distinguished from myoma using ultrasound and hCG. Usually the belly grows, but the analysis shows no pregnancy. At the same time, the ultrasound clearly shows a tumor, which can be malignant or benign.

Differentiation from other inflammatory diseases of the genitourinary and reproductive systems is done using tests and smears. A routine blood test may indicate an inflammatory process.

Differentiation from intestinal tract diseases is based on smear and ultrasound results. If the results do not confirm pregnancy and do not indicate the presence of pathology in the reproductive organs, a consultation with a gastroenterologist who diagnoses gastrointestinal diseases may be required.

Acute appendicitis or other pathology requiring immediate surgical intervention is characterized by high temperature, sharp, increasing pain. Leukocytosis in the general blood test indicates such pathology.

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Treatment lower abdominal pulling sensations at 4 weeks' gestation

If you have pain in the lower abdomen in the 4th week of pregnancy, you do not need treatment. Of course, this is if the pain is physiological. A woman should accustom herself to pain, or rather, learn not to notice it. This will significantly help her in the future at a later stage, and will make childbirth easier. The ability to control pain and not notice it is very important for a pregnant woman, so you need to start training yourself even in the early stages.

Of course, to do this, you need to make sure that the pain is not pathological in nature and does not threaten either the health of the woman herself or the health and life of the child.

At this time, you need to start practicing proper breathing, relaxation, meditation, and augen training, which are the best, natural method of preventing and treating any pain. It is always better to avoid medications, especially at such early stages, because all medications have a negative effect on the fetus. There are no drugs that are completely safe. And the first 4 weeks are perhaps the most important period in the development of the baby, since it is at this time that the main organs are laid. At this time, there is a high risk of developing congenital defects, which increases even more when taking medications.

Medicines

If the pain is so intense that it causes obvious discomfort to the woman, some medications can be used. But this should be done only in cases of extreme necessity. It is always necessary to remember that physiological pain is natural, and therefore it is better to eliminate it in natural ways. It is recommended to take medications if the pain does not go away with complete relaxation, when changing position. It is better to take gentle medications that have a minimal effect on the developing fetus.

For severe spasms and pain, no-shpa is effective. It relieves spasms, relaxes muscles, and reduces pain. It should be taken 50 mg no more than 1-2 times a day.

If the cause of pain is constant swelling, suprastin is recommended, 1 tablet (150 mg) – 1-2 times a day.

If pain in the lower abdomen is accompanied by intense headaches, you can take cinnarizine - 50 mg 2-3 times a day.

In case of severe edema accompanied by nausea, vomiting, lower abdominal pain, headaches, it is recommended to take 10 ml of 2.4% solution of euphyllin diluted in 10 ml of saline. The drug is administered intramuscularly or intravenously. It can be used to provide emergency care for complications of bronchial asthma, suffocation. Despite the fact that it has an almost instant effect, it is an unsafe remedy with serious side effects. It should be used only under the supervision of a doctor. It is also recommended to administer the drug in the presence of medical personnel or with their help. It has a strong diuretic, hypotensive effect, improves blood microcirculation and its coagulation functions.

Vitamins

Every person needs vitamins. Pregnant women need twice as many. It is recommended to take vitamins daily in the following dosage:

• Vitamin H – 150 mcg
• Vitamin C – 1000 mg
• Vitamin PP – 60 mg
• Vitamin D – 45 mcg
• Vitamin K – 360 mcg.

Physiotherapy treatment

The use of physiotherapy has a positive effect on the body, stimulates the immune system, and promotes faster recovery. Not all means can be used during pregnancy. But many of them are not only harmless, but also useful. Physiotherapy can be used in the treatment of other diseases of the pregnant woman as part of complex therapy. For example, for the treatment of colds, inflammations of various localizations. The main advantage is that with the help of physiotherapy means recovery occurs much faster, which means that fewer medications will be required, the use of which is extremely undesirable for the unborn child.

Physiotherapy is also used to treat gynecological diseases and to maintain the normal course of pregnancy. For example, with the help of physiotherapy in the early stages, various obstetric pathologies can be eliminated, inflammatory diseases of the genitals can be cured. Even with the threat of miscarriage or spontaneous abortion, some physiotherapeutic means can help to maintain pregnancy.

Electrophoresis and other methods of electrical action on the body are used quite often during pregnancy. With the help of these methods, a low-voltage current is passed through the body. It promotes faster and deeper penetration of drugs into tissues. In this case, the impact on the fetus will be minimal, and much less medicine is required. It is used in the treatment of various diseases, including obstetric ones.

Electrophoresis with magnesium is often used to treat lower abdominal pain. The ions penetrate deep into the tissues, facilitating their relaxation. The pain is significantly reduced. Hypertonia can also be eliminated in this way. This procedure does not harm the fetus.

If the pain is accompanied by excessive toxicosis, endonasal electrophoresis and galvanization are used, which also significantly accelerate the process of muscle relaxation and facilitate the direct penetration of drugs, bypassing the fetus.

Treatment with inhalations, phonophoresis, and laser exposure may be safe for pregnant women. Reflexology, acupuncture, and massage may be recommended.

Folk remedies

Folk remedies can be effective in treating nagging pain in the lower abdomen in the 4th week of pregnancy. Before using any remedies, you should consult a doctor, as many remedies may be contraindicated for pregnant women. Some substances may have abortive properties during pregnancy.

White birch is used to treat lower abdominal pain. Birch leaves and young twigs with buds collected in early spring are especially useful. If you feel lower abdominal pain, take a birch twig or 10-15 leaves and pour a glass of boiling water over them. After the decoction has steeped, you can drink it in small sips. It should be drunk warm.

For pain, hot and cold compresses on the abdominal area are effective. You can take mistletoe and brew a strong decoction. Several sprigs of mistletoe are poured with about 500 ml of boiling water, gauze or a rag is soaked in this solution and applied to the area where pain is felt. You can add birch bark to the prepared decoction. The composition of the collection for external use can be varied.

To make a cold compress, soak gauze in a cold decoction and apply it to the lower abdomen. As soon as the gauze begins to heat up, soak it in the decoction again and apply it to the same place.

If you are making a hot compress, you need to soak gauze in a warm, but not hot decoction, apply it to the lower abdomen. Put oilcloth or cellophane on top, which will retain heat. Cover the cellophane with a thick layer of cotton wool or wool. After that, tie a warm scarf on top. Usually such a compress is enough for 30-40 minutes. If the pain does not go away, the compress needs to be changed, soak the gauze in a warm decoction again.

One of the most effective means that helps reduce pain is meditation, relaxation. A woman needs to get used to painful and pulling sensations, if they are not pathological. Meditation helps to concentrate attention, teaches the ability to consciously control your sensations, influence the perception of pain, reduce painful sensations by willpower, and also by relaxing muscles. This will significantly help during childbirth.

You need to sit down and straighten your back. Your back should be in a straight line. To begin with, it is better to sit against the wall and straighten your back along it. Close your eyes. Then you need to focus on your breathing. When you inhale, your stomach rises up and expands as much as possible. When you exhale, your stomach drops and presses against your spine. We try to remove all thoughts and distract ourselves from everyday worries. Attention is focused only on the breathing process. You also need to try to distract yourself from extraneous factors and relax as much as possible. You need to start this exercise with 15 minutes, gradually increasing the meditation time to 1.5 – 2 hours per session.

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Herbal treatment

Despite the fact that medicinal plants are effective means of muscle relaxation, pain relief, their uncontrolled use can have serious negative consequences. Nausea, vomiting, dizziness and even bleeding may occur if taken incorrectly, in case of overdose. During pregnancy, intolerance to individual components may occur, even if such reactions did not occur before pregnancy. It is necessary to remember that not all medicinal herbs have a positive effect on the woman's body and on the fetus's body. In any case, before taking them, you need to consult a doctor.

If you suffer from prolonged pain and nausea, you can use yarrow, which is drunk as a decoction or infusion. To prepare a decoction, pour boiling water over a handful of dry grass, drink it after cooling during the day. To prepare an infusion, pour vodka or alcohol over the grass. You need to give the infusion time to brew. You can drink it after about a week, 1-2 teaspoons when pain appears.

Stinging nettle helps relieve swelling, reduces migraines and headaches. In case of excessive drowsiness and lack of strength, it is also recommended to drink a decoction of nettle. Use the stems and leaves of nettle. About one medium stem with leaves should be finely chopped, pour 2-3 glasses of boiling water. Drink during the day in small sips. You can also use nettle as part of tea. To do this, add 1 medium sprig of nettle to a teapot with tea and let it brew. Drink like tea, when thirsty or painful.

Hibiscus tea has proven itself well. Brew it like regular tea and drink it throughout the day. If necessary, add sugar or honey to taste. Eliminates swelling, restores strength, normalizes metabolism. Contains vitamin C.

Homeopathy

Homeopathic remedies are effective in treating lower abdominal pain in the 4th week of pregnancy. It is recommended to take precautions: take medications only after prior consultation with a doctor. It is necessary to carefully select the remedies, since some of them are contraindicated during pregnancy. It is necessary to remember that there are remedies that have many undesirable side effects, including having an abortive effect. Some drugs are contraindicated at such an early stage of pregnancy.

• Collection No. 1. For pain and swelling

The ideal remedy would be a mixture of nettle and stevia in equal parts. Then take about 1-2 tablespoons of the herb from this mixture, pour boiling water over it and drink throughout the day. You can make a light decoction, for this the herb is poured with about 1-2 liters of water and drunk throughout the day. You can make a more concentrated decoction, for which the herb is poured with about 2-3 glasses of boiling water, infused and drunk throughout the day.

• Ointment for pain in the lower abdomen

If you suffer from prolonged pain in the lower abdomen, you can use an ointment that is applied to the lower abdomen or to the area that hurts. To prepare the ointment, melt about 100 g of butter over high heat. While the butter is boiling, add chopped turmeric or ginger root, Altai honey, and milk thistle seeds. Stir constantly and bring to a boil. After this, remove the mixture from the heat and pour it into a jar or mold. Allow it to cool. After the ointment has cooled, place it in the refrigerator so that it can harden. After hardening, apply it to the lower abdomen like a cream when painful sensations appear.

• Elixir "Taiga Healer"

It is used for pain in the lower abdomen, nausea, dizziness. To prepare, add sea buckthorn berries, marshmallow root, propolis, and nettle leaves to 500 ml of vodka or alcohol. All these additives should take up about a third of the container with vodka. Then close and let it brew. After the solution has changed color, you can drink it as pain appears. It is recommended to drink no more than 50 ml of the solution at a time; the course of treatment should not exceed 2 weeks. You can take a break and then start treatment again.

• Syrup "Pleasant pregnancy"

The syrup can be bought ready-made in a pharmacy or prepared at home. To prepare it, you will need 500 ml of rosehip syrup. Add 50 ml of echinacea extract and 50 ml of eleutherococcus extract to it. Mix well, let it brew (2-3 hours is enough for this). Then drink the syrup in its pure form, 3-4 tablespoons a day or add it to tea to taste.

Surgical treatment

In case of pain in the lower abdomen, surgical intervention is not required. The exception is cases when pain occurs as a result of diseases of other organs and systems. In case of acute surgical pathology, in case of ectopic pregnancy, urgent surgical intervention is required. In case of bleeding, miscarriage, urgent surgical intervention is also required. In case of tumors, growths, urgent surgery may also be required to remove them.

Complications and consequences

Only physiological pains do not entail complications and consequences. They disappear on their own by the end of the first trimester and do not even require additional treatment. Pains of a pathological nature can be life-threatening and health-threatening. They are dangerous for both the baby and the mother. They can end in a miscarriage, abortion, ectopic pregnancy. Pathological pains can result in inflammatory and infectious diseases of the reproductive organs. More severe complications can be malignant or benign tumors, myomas, fibroids. If pain is given from other organs, their inflammation may occur. A dangerous complication is acute surgical pain, which requires urgent surgical intervention.

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Prevention

Prevention comes down to proper and nutritious nutrition, drinking plenty of fluids. It is also necessary to follow a daily routine, exercise regularly. It is imperative to include breathing and relaxation practices in your practice.

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Forecast

If the pain is physiological, the prognosis is favorable. The pain usually goes away on its own, without any intervention or medication. The pain stops bothering the woman after 2-3 months. If the woman does breathing and relaxation practices, the pain goes away much faster, after about 1.5-2 months. In any case, if the lower abdomen is pulling in the 4th week of pregnancy, you should immediately consult a doctor.

If the pain is pathological, the prognosis may vary. It all depends on the cause of the pain.

An extremely unfavorable prognosis, including a fatal outcome, is possible if timely measures were not taken in urgent and acute conditions, in case of miscarriage, spontaneous abortion, bleeding, ectopic pregnancy. However, if you contact a doctor in a timely manner, calling an ambulance, and strictly follow the doctor's recommendations, the prognosis may be favorable.

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