Why is the lower abdomen pulling at 5 weeks of pregnancy and what to do?

The internal sensations of expectant mothers in the fifth week may be different: some have the body working as before - before pregnancy, while others begin a period of early toxicosis, which causes considerable discomfort. It often happens that the lower abdomen is pulled in the 5th week of pregnancy - this symptom is not always considered unfavorable, but it is still right to consult a specialist as soon as possible.

Epidemiology

Situations when the lower abdomen is pulled at 5 weeks occur in almost every second woman who is in an "interesting position" and in the overwhelming majority of cases the causes of discomfort are physiological, when there is a gradual increase in the uterine organ with stretching of the muscle fibers and ligaments. A woman will encounter physiological sensations during pregnancy more than once, since the uterus will continue to develop and increase, putting pressure on the organs located nearby: the bladder, liver, digestive system. At later stages, such sensations will be associated with the preparation of the musculoskeletal structures for labor: the pelvic bones diverge so that the baby's exit into the outside world is more comfortable for him.

And only in 2-25% of pregnant women (according to various sources) discomfort in the lower abdomen can be associated with a pathology, which we will discuss below.

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Causes lower abdominal pain at 5 weeks' gestation

A symptom such as nagging pain in the lower abdomen in the fifth week can be physiological or pathological.

Physiological causes of this symptom can be discussed when discomfort in the lower abdomen is associated with an increase in the volume of the uterus: during the enlargement of the organ, not only the myometrium stretches, but also the supporting muscle groups and ligaments. This manifests itself in pulling, painful and uncomfortable sensations in the pelvic area.

However, many expectant mothers may have a pathological cause for the pulling sensations - most often it is hypertonicity of the uterine organ with an increased risk of spontaneous termination of pregnancy (miscarriage). In such a condition, the pain is very similar to that in the first days of the menstrual cycle. You should be especially wary if the unpleasant sensations are accompanied by "smearing" from the genital tract (usually these are red-brown smears). You should not exclude the possibility of full-fledged bleeding: in such a situation, you must immediately call an ambulance, since there is a high risk of losing the baby.

When considering the causes of a nagging discomfort in the abdomen in the fifth week, it is necessary to take into account those situations that are not related to the reproductive organs. For example, sometimes aching pain can indicate problems in the intestines or a digestive disorder.

Most often, pulling sensations in the lower abdomen at 5 weeks can appear in the following situations:

• with multiple births;
• in case of endocrine disorders (for example, diabetes);
• for appendage cysts;
• if there are inflammatory diseases of the reproductive organs;
• after abdominal injuries, after unsuccessful falls;
• in case of severe hormonal imbalance;
• in women with endometriosis or adhesions in the pelvis.

Women who have previously had episodes of miscarriage, abortions, or ectopic pregnancy should be especially attentive to their feelings.

Risk factors

• Previously performed artificial abortions or curettage of the uterine cavity.
• Contact sexually transmitted infections, hormonal imbalances, diseases of the hematopoietic system and cardiovascular system.
• Severe stress, depression, neuroses.
• Heavy physical exertion, carrying heavy objects, injuries, falls, concussions.
• Having unhealthy habits (drinking alcohol, smoking, taking medications).
• Rhesus (-) blood.
• Endometriosis, adhesions.
• Multiple pregnancy.

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Pathogenesis

Since there may be several reasons for the appearance of pulling sensations in the lower abdomen at 5 weeks, it is important to contact the gynecology department in time to save the baby.

• Increased uterine tone is a sharp contraction of its muscular layer, which can provoke a miscarriage. It is very dangerous if the pulling sensations are accompanied by pain or turn into pain, if discharge from the genital tract is additionally detected. If the symptoms listed above are present, medical attention should be sought immediately.
• Pulling sensations in the lower abdomen around the 5th week, accompanied by a small amount of blood from the genital slit, as well as digestive disorders (nausea - to vomiting, dyspepsia) may be a consequence of an approaching miscarriage or frozen fetal development. In such a case, you should also not delay a visit to the doctor.
• Inflammation of the reproductive organs, congenital anomalies in the development of the genital area, infectious diseases that are transmitted through sexual contact - such factors can also cause a nagging discomfort in the lower abdomen. To clarify the cause of discomfort, it is necessary to undergo appropriate diagnostics. This must be done - after all, many diseases can further interfere with the normal development of pregnancy, or cause various problems during childbirth.
• In case of ectopic pregnancy, the situation when the lower abdomen is pulled is not uncommon. After all, the fertilized egg, being fixed and developing outside the uterine cavity, causes stretching of the muscles and ligaments of other organs - appendages, tubes, and also pelvic organs. The described condition is considered really dangerous and requires immediate surgical intervention.

Despite the large list of possible negative factors for the appearance of unpleasant pulling symptoms in the lower abdomen, you should not panic. You just need to immediately contact a medical institution: a specialist will conduct the necessary examination and accurately indicate the cause of this phenomenon. It is quite possible that there is absolutely no reason to worry.

Symptoms lower abdominal pain at 5 weeks' gestation

Physiological pulling sensations in the lower abdomen, if they are not caused by any pathology, often manifest themselves independently, without being accompanied by other symptoms. Only some pregnant women may experience slight back pain, fatigue, and drowsiness.

Often, early toxicosis begins in the fifth week of pregnancy, which can also occur with a pulling sensation in the lower abdomen, as well as with other characteristic symptoms:

• nausea, morning vomiting;
• increased salivation;
• changes in body weight;
• loss of appetite;
• lowering blood pressure;
• increased heart rate;
• irritability.

If the pulling sensation in the lower abdomen is a symptom of pathology, then at the same time you can notice other characteristic early signs:

• bloody discharge from the genitals;
• menstrual-type bleeding;
• abdominal pain (like during menstruation);
• back pain;
• dizziness, weakness in the legs.

If a pregnant woman discovers such symptoms, she needs to urgently contact a gynecologist at the clinic. The same applies to cases of severe toxicosis: for example, profuse and frequent vomiting is also considered a good reason for an urgent visit to the doctor.

Complications and consequences

According to statistics, most pregnant women experience lower abdominal pain in the 5th week – and this is explained by ordinary physiology: such symptoms do not pose a threat either to the fetus or to the woman herself.

But it is important to remember that this does not always happen: discomfort can also be associated with pathological changes in the body. The consequences of such changes can be:

• spontaneous termination of pregnancy;
• cessation of development of the fertilized egg (fading pregnancy);
• ectopic pregnancy.

The first two consequences are most often diagnosed during this period – in the fifth to sixth week of pregnancy, which is why many specialists call this time critical.

As for an ectopic pregnancy, this condition cannot be corrected. However, timely visit to a doctor will help to avoid much more serious complications, such as peritonitis - inflammation of the abdominal cavity.

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Diagnostics lower abdominal pain at 5 weeks' gestation

In order to determine the reason why the lower abdomen is pulling at 5 weeks, the complaints of the pregnant woman alone will not be enough for the doctor. For an adequate assessment of the situation, first of all, it is necessary to take tests:

• general and biochemical blood analysis;
• general urine analysis.

Depending on the pathology, changes in the level of hemoglobin, leukocytes, and an increased hematocrit may be detected in the blood.

In the presence of metabolic disorders, a change in the content of calcium and sodium in the blood, an increase in the level of urea, creatinine, AST and ALT may be detected.

In case of pathology, protein, ketone bodies and acetone are detected in the urine fluid.

Instrumental diagnostics is often limited to two types of studies, which are considered the most informative and reveal the full picture of the situation:

• ultrasound examination – usually performed after the 14th week of pregnancy, but doctors may perform it earlier if indicated. For example, starting from the fifth or sixth week, it is possible to predict the course of pregnancy, assess the fetal heartbeat and the location of the chorion. Ultrasound helps to see an ectopic pregnancy in a timely manner, diagnose a frozen pregnancy, and also assess the tone of the uterus;
• laparoscopy – during pregnancy it is performed only for therapeutic and diagnostic purposes (for example, in case of appendicitis, ovarian torsion, cyst, malignant tumor, and also in case of ectopic pregnancy).

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Differential diagnosis

Acute appendicitis	The pulling sensation turns into pain, which is localized in the navel area, gradually moving to the right iliac region.
Ectopic pregnancy	The pulling sensations may develop into pains radiating to the rectum and external genitalia. False urges to defecate are often observed. The posterior vaginal fornix is painful.
Threat of miscarriage	The pulling sensation is accompanied by bleeding from the genital slit. The tone of the uterus is increased.
Ovarian apoplexy	The pulling sensation quickly gives way to sharp pains from the affected ovary.
Acute inflammation of the appendages	Pulling and painful sensations are accompanied by an increase in body temperature. The appendages are painful when palpated.

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Treatment lower abdominal pain at 5 weeks' gestation

If you feel a pulling sensation in the lower abdomen in the fifth week, treatment can only be prescribed if the cause of this condition requires it - for example, in the case of a threatened miscarriage or early toxicosis.

If the lower abdomen is pulling for physiological reasons, then treatment is not required.

If necessary, complex therapy is used, including medications and auxiliary treatment measures (establishing a gentle regimen, diet, physiotherapy, psychotherapy, etc.).

Establishing a routine and changing your diet are important steps to prevent the threat of miscarriage. For a woman in the fifth week of pregnancy, it is very important to have adequate healthy sleep and quality nutrition, no stress or fear, moderate physical activity, and often – sexual rest.

In some cases, a pregnant woman in the fifth week is recommended to consult a psychologist - the early stage of pregnancy is often accompanied by excessive emotional stress, worries, phobias.

However, it also happens that you cannot do without medication. Depending on the causes of the pulling sensations in the lower abdomen, the doctor may recommend taking certain medications.

Medicines

• Sedatives:

1. motherwort in tablets (1 tablet 2-3 times a day);
2. valerian in tablets - valerian extract, Valeriana forte, Dormiplant, Valdispert (1-2 tablets at night).

• Antispasmodic drugs:

1. such drugs as Papaverine or No-shpa (the same Drotaverine) help to relax the myometrium and have a good effect on uterine hypertonicity. Such drugs can be prescribed in the form of tablets or intramuscular injections, and Papaverine is often used rectally in the form of suppositories (1 piece per night);
2. Magnikum, Magne-B ₆ tablets also perfectly regulate uterine tone, normalize the nervous system, and also help get rid of night cramps. Any of these drugs can be taken 1 tablet 2-4 times a day, as prescribed by a doctor.

• Hormonal agents (they are used only after assessing the level of hormones in the blood):

1. Progesterone (Duphaston, Iprozhin, Prajisan, Utrozhestan) - these drugs replace the main hormone in the female body, which ensures the maintenance of pregnancy. Duphaston is taken 1 tablet once every eight hours, or according to an individual scheme selected by the doctor. Utrozhestan is taken in the amount of 100-200 mg daily. Both drugs are tolerated by the body quite well: only in some cases dyspepsia and changes in appetite are possible;
2. Glucocorticosteroid hormones (for example, Metipred or Dexamethasone) can be prescribed in individual quantities in case of immune disorders or hyperandrogenism.

• Medicines to stop bleeding are prescribed in the presence of bloody discharge. Such medicines include Ascorutin, vitamin K, Dicynone - they reduce vascular permeability, improve capillary blood circulation, and affect blood clotting processes.
• Vitamins are prescribed not only to prevent the threat of miscarriage, but also for the normal development of pregnancy and the fetus. In addition to the above-mentioned Magnikum (or Magne-B ₆ ), doctors often prescribe tocopherol (vit. E), folic acid, other B vitamins, as well as complex preparations for pregnant women - Vitrum prenatal, Elevit pronatal, etc.

Physiotherapy treatment

Physiotherapy may be prescribed by a doctor as an additional non-drug therapy:

• Electroanalgesia method – soothes and eliminates minor pulling painful sensations in the lower abdomen.
• Electrophoresis with magnesium – promotes relaxation of the myometrium, normalizes uterine tone.
• Reflexive electrorelaxation is a method of reflexive muscle relaxation, which helps to quickly relieve hypertonicity.
• The hyperbaric oxygenation method involves the use of oxygen in special chambers. The method improves blood circulation, eliminates tissue hypoxia, and helps remove toxic substances from the body.
• Acupuncture and reflexology are procedures that help not only stabilize uterine tone, but also normalize blood pressure, reduce psycho-emotional stress, and improve sleep.

Folk remedies

If you have a pulling pain in your lower abdomen in the 5th week of pregnancy, then in the initial stages, regular folk methods can help, which can be divided into two categories: what you can’t do and what you need to do in such a situation.

• Not recommended:
  • drink black tea and coffee, as well as soda;
  • eat dark chocolate;
  • eat dishes made from cabbage, peas, beans (this can increase the tone of the uterus);
  • consume products with chemical additives;
  • go to the steam room or sauna;
  • follow any diets to lose weight;
  • take a hot shower or bath;
  • steam your feet;
  • lift heavy objects (more than three kilograms);
  • worry, quarrel;
  • ride a bicycle and use other means of transport;
  • smoke, drink alcohol.

• Need to:
  • rest more, walk, sleep;
  • listen to classical or other light music;
  • eat plant foods, white meat, drink fresh juices or compotes.

For a normal pregnancy, many experts recommend inhaling the aroma of calming and relaxing herbs - for example, mint, thyme, lemon balm, valerian root or hop cones. This will help you calm down and tune in to a positive mood.

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Herbal treatment

During pregnancy, including in cases where the lower abdomen is pulling, herbs are taken very carefully and only on the recommendation of a doctor. In case of discomfort in the abdominal area, the following recipes using herbs may be relevant:

• Five grams of dandelion rhizome are poured with 200 ml of water and boiled for five minutes. Drink 50 ml in the morning, before lunch and before bed.
• One teaspoon of ground viburnum bark is poured with 200 ml of water and boiled for 5 minutes. Drink 2 tablespoons three times a day.
• Thirty grams of viburnum flowers are poured into a thermos and filled with boiling water, left for 2 hours to infuse. Drink 50 ml before breakfast, lunch and dinner.
• Prepare a mixture of 10 g of St. John's wort and 10 g of calendula, pour in 400 ml of boiling water, and leave for 30 minutes under a lid. Drink the resulting amount of drink during the day, adding honey to taste.

Homeopathy

You can get rid of the pulling sensations in the lower abdomen in the 5th week with the help of homeopathic remedies, which are represented by many effective drugs. For example, discomfort associated with early toxicosis in the fifth week of pregnancy can be eliminated with the help of Sepia, Ipecacuanha, Lacticum acidum and Cocculus indicus, as well as Colchicum.

Any of the listed homeopathic medications are taken three times a day until a stable improvement occurs. If after finishing taking the medication the pulling sensations resume, then the treatment is allowed to be repeated.

If the lower abdomen is pulling at 5 weeks, and this is associated with the threat of miscarriage, then homeopathic preparations are taken 4 times a day until the normalization of the pregnancy. If a woman has already had cases of miscarriage, then homeopathy should be taken three times a day, from the very beginning of pregnancy and until about the sixteenth week.

In case of threatened miscarriage, the most effective means are:

• Aconite – will help with the threat caused by stress;
• Arnica – eliminates hypertonicity associated with a fall or injury;
• Belladonna – can be used to eliminate bloody discharge, painful pulling sensations in the abdomen and back;
• Sabina - prescribed for severe bleeding and acute pain in the lower abdomen;
• Viburnum is used in cases of threatened spontaneous abortion.

Surgical treatment

If you have a pulling pain in your lower abdomen at 5 weeks, then surgery is only performed in emergency cases:

• in case of ectopic pregnancy;
• for cysts and other neoplasms requiring urgent surgical intervention.

Typically, such operations are performed using laparoscopy, a gentle intervention that involves minimal tissue damage and a quick recovery period.

During pregnancy, laparoscopic surgeries are performed relatively often. However, if possible, they are postponed until the second trimester, when the main processes of laying down the organs of the future child are coming to an end.

If laparoscopy is prescribed to a pregnant woman, it is very important to correctly select an anesthetic during the operation and accurately calculate its amount so as not to harm the fetus. The risk of early and premature birth during laparoscopy is reduced to a minimum, so there is no need to worry about the further normal course of pregnancy.

Prevention

Preventive measures regarding the appearance of pulling and uncomfortable sensations in the abdomen during pregnancy should be considered during the planning period, or at the moment when a woman becomes aware of her “position”.

So, unpleasant sensations in the lower abdomen can be prevented if you follow simple medical recommendations:

• It is necessary to visit a gynecologist at the first signs of pregnancy - for example, after taking a test;
• Be sure to follow all doctor's advice;
• Immediately after pregnancy, you must definitely give up smoking and drinking alcohol (and it is even better to do this much earlier);
• If possible, it is necessary to avoid stressful situations, scandals, mental and physical overload;
• it is advisable to rest more, sleep well, walk, breathe fresh air;
• you should avoid any restrictive diets, dry food, processed foods and unhealthy foods;
• It is not advisable to travel long distances, especially to fly on an airplane or to drive on bad roads;
• You must not take any medications without permission and prescription from a doctor;
• You should take care of your health: avoid possible accidental falls, avoid large crowds of people (especially during flu and cold epidemics).

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Forecast

Some women, mainly due to lack of experience or due to their inherent carelessness, ignore the moment when the lower abdomen is pulling in the 5th week of pregnancy. If you close your eyes to such a symptom, you can miss the development of irreparable complications - up to the loss of the child. Often there is a danger to the health of the woman herself. Therefore, at the first suspicious symptoms - if the lower abdomen is pulling, or there are other negative signs - you need to immediately contact a doctor who will answer any questions about your pregnancy. To make sure that the prognosis for the life and health of the future child is favorable, it is better to play it safe and get examined.

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