Why pulls the lower abdomen in pregnancy and what to do?

Every second woman experiences a pulling sensation in the lower abdomen during pregnancy. Often, this is an unnecessary concern, but one should not forget about the pathological conditions that can cause such a symptom. In order to protect your life and the health of your future child, you need to clearly know the main pathologies that can cause such pain.

Epidemiology

The epidemiology of this problem by etiological factors is characterized by the fact that more than 65% of cases of such pain are caused by stretching of ligaments and muscles, and therefore such pain does not pose a potential threat. But the remaining 35% is a very large number of complications that can cause such pain. According to statistics, only 88% of women with such symptoms are admitted to hospital in time, which threatens termination of pregnancy. In 80% of women, nagging pain caused by a serious disease is accompanied by other symptoms, which proves the need for complete diagnostics and knowledge of these additional clinical manifestations.

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Causes lower abdominal pulling pain in pregnancy

There can be many reasons for nagging abdominal pain during pregnancy, but it is important not only to know about them all, but also to understand where the line is when this is no longer a normal phenomenon and when it is necessary to seek advice. The period of pregnancy is also very important, because depending on this, certain disorders occur that entail such pain.

Before we look into the causes, we need to talk about the risk factors for this pathology. Women who are going to become mothers for the first time have a higher risk of developing such symptoms only because the uterus and all the abdominal and pelvic floor muscles are not ready for such a load. The uterus stretches with increasing pregnancy, and since it is a muscular organ, only this can cause such sensations. Together with the uterus, the abdominal muscles also stretch - this leads to the lengthening of muscle fibers, which is why a pulling pain can be felt. These phenomena are normal and can occur in every woman, and they do not pose any danger. The only question is to determine the pathological condition when it is worth intervening. Among such conditions, it is necessary to highlight inflammatory diseases of the internal genital organs. Women who have had a history of chronic adnexitis or a cyst, or another source of infection have very high risk factors for complications during pregnancy, and one of the manifestations of such complications can be just such a sensation in the lower abdomen. In this case, such a symptom can often indicate an exacerbation of the disease. Therefore, one of the reasons that the lower abdomen pulls during pregnancy may be an infectious inflammation of the tubes or ovaries. The pathogenesis of the clinical picture is that the infectious process spreads to neighboring structures - this irritates the pain receptors of the peritoneum covering the uterus or ovaries, which causes a nagging pain. But it should be noted that the inflammatory process may not always have a strong manifestation, and the symptoms may be sluggish - which, in addition to the nagging pain, may not cause other symptoms.

Other etiological factors of such pain syndrome are the threat of miscarriage or its beginning. Premature termination of pregnancy is now a very common problem due to many reasons. This problem refers to complications of the first trimester of pregnancy, when the fetus is most vulnerable. For one reason or another on the part of the fetus or mother, a nagging pain in the lower abdomen begins, which corresponds to the beginning of a miscarriage. The pathogenesis of this disease is associated with rhythmic contractions of the uterus of the same nature as during childbirth, which causes a gradual detachment of the ovum and its exit. This is a life-threatening condition for a woman and it is very important to diagnose it in time, because you can still save the child.

A very important reason for a nagging pain in the lower abdomen is an ectopic pregnancy. Under normal conditions, on the seventh day after fertilization of the egg, the embryo moves along the fallopian tube and is implanted in the uterine cavity, where it then develops. When, for certain reasons, the embryo cannot reach the uterus, it is implanted in the tube or comes out of it and gets on the ovary or into the abdominal cavity, this is an ectopic pregnancy. Over time, the embryo grows and there is little space, which leads to stretching of the tube and the appearance of symptoms. And the first symptom is most often a nagging pain in the abdomen.

A ruptured cyst or simply its presence, which was not previously diagnosed or was asymptomatic, can cause pain syndrome of such localization. A cyst, located on the ovary, leads to its irritation, stretching and the appearance of symptoms. Then the cyst can behave calmly throughout the pregnancy, or it can grow and progress.

Late pregnancy can carry the potential danger of placental abruption, a condition often accompanied by nagging pain. But there are other symptoms, so don't focus on pain alone to diagnose the condition in time.

At any stage of pregnancy, such pain may be a manifestation of acute pathology of the urinary tract. In this case, one should think about renal colic or acute gestational pyelonephritis. Careful differential diagnostics are simply necessary for the correct treatment tactics.

These reasons are only the most common, and in order to correctly assess the situation, you must first focus on the nature and intensity of the pain, which can predict a potential threat to the life of both the mother and the child.

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Symptoms lower abdominal pulling pain in pregnancy

If the pain is caused only by stretching of the abdominal muscles and uterine fibers, then the clinical picture is limited to only a periodic feeling of heaviness in the lower abdomen, as during menstruation. As the pregnancy progresses, these sensations may increase. But this is the only symptom in this case, which appears from time to time and is not constant. It does not disturb the general condition of the woman and does not entail any problems.

If, in addition to the nagging pain in the lower abdomen, there are other signs of the disease, then one should think about organic pathology. For example, inflammatory diseases of the appendages during pregnancy can become active, then pain appears, as well as an increase in temperature, which is inherent in any inflammatory process. The increase in temperature itself and signs of intoxication can already indicate that this is serious. There may also be purulent discharge from the vagina, or simply unpleasant discharge or discomfort.

If you have a pulling pain in your lower abdomen in the first trimester of pregnancy, this may be a sign of a threat of premature termination. In this case, only spasmodic pains in the lower abdomen are observed, which are repeated. If this is accompanied by bloody discharge, then we are already talking about a miscarriage in progress, and then it will not be possible to save the child. That is why, in the event of such intense pain, you must contact a doctor immediately, and not wait for the symptoms to pass.

If the lower abdomen is pulling in the second and third trimester, the cause may be either premature birth or placental abruption. The tactics are very different for all these pathologies. The first signs of premature birth are the same as for normal birth, that is, pain in the lower abdomen. Sometimes in the last weeks before childbirth, a woman can suddenly feel such a heaviness that it will not be accompanied by the discharge of water or the onset of labor. Then we are talking about a pathological preliminary period, in which false contractions do not lead to normal opening of the cervix.

If you have a strong pulling pain in your lower abdomen during pregnancy and this is accompanied by bloody discharge already in the later stages, then you need to exclude placental abruption. But there may not be bloody discharge, so you need to focus only on the intensity of the pain.

When walking, the lower abdomen hurts during pregnancy, most often due to physical exertion, then it is recommended to rest, and the symptoms should go away.

If the lower abdomen and lower back are pulled during pregnancy, then most likely the woman has pyelonephritis. This is an inflammation of the kidneys, which is also accompanied by a violation of urination. In this case, the pulling can be on one side - on the right or left. Other symptoms of this disease can be such as cloudy urine, fever, headache and muscle pain.

If the lower abdomen is pulled during urination, then most likely it is inflammation of the lower urinary tract. Cystitis is a common disease of pregnant women due to compression of the bladder. There is also pain during urination, burning, frequent urination and frequent urges.

If you have a pulling sensation in your lower abdomen and diarrhea during pregnancy, you need to rule out food poisoning. This may also be accompanied by symptoms of vomiting and nausea, which will lead you to think about poisoning.

Thus, a nagging pain in the lower abdomen is only one symptom, and to fully characterize the condition, it is necessary to evaluate others in order to provide timely assistance.

Complications and consequences

The consequences of nagging pain depend on the cause and the urgency of the assistance provided. If there is a threat of miscarriage, the child can be saved, but if the miscarriage has already begun, then unfortunately, treatment will not help. Speaking of inflammatory diseases, untimely treatment of such processes can cause intrauterine infection and lead to further complications - chorioamnionitis, congenital pneumonia of the fetus, congenital defects. The consequence of untimely diagnosis of placental abruption can be a large retroplacental hematoma, which will ultimately lead to the need to remove the uterus.

Complications that arise against the background of only one symptom - heaviness in the lower abdomen - can be very serious, which you should know in order to prevent them, not treat them.

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Diagnostics lower abdominal pulling pain in pregnancy

Diagnosis of pulling pains in the lower abdomen should be timely, then all complications can be prevented. Therefore, it is necessary to exclude all pathological conditions, and only then say that this is a normal phenomenon during pregnancy.

First, it is necessary to establish all the anamnesis data and clarify the pregnancy period, the nature of the pain, and how it is related to the load. Sometimes the fact that the pain goes away after rest may indicate its physiological nature. It is important to clarify whether the nature of the discharge has changed and whether the body temperature has increased.

The tests should exclude a pathological condition, and therefore general tests are sufficient for general diagnostics. A general blood test helps to exclude an inflammatory process, otherwise, there will be leukocytosis and a shift in the formula to the left. A general urine test helps to establish the function of the kidneys and urinary tract. Any increase in leukocytes or protein may indicate inflammation. Then the diagnosis can be confirmed objectively - a positive Pasternatsky symptom indicates pyelonephritis.

If placental abruption or a threat of abortion is suspected, a vaginal examination is mandatory, which helps to determine the stage of the process. The degree of opening of the internal cervical os during a miscarriage indicates the stage of the abortion and whether it is necessary to maintain the pregnancy or this will no longer be possible. In case of placental abruption, there may not be any external bleeding, in which case it is necessary to determine the volume of blood loss using instrumental methods.

Ultrasound examination allows to accurately determine the condition of the fetus, the location of the ovum and can accurately exclude one or another condition. It is also possible to assess the condition of the kidneys and the presence of obstruction, that is, to diagnose pyelonephritis and urolithiasis. In the late stages of pregnancy, the main method for diagnosing the condition of the uterus and the child is cardiotocography. This method allows to determine the tone of the uterus, which plays a major role in the appearance of such nagging pains. And after this, it is possible to judge premature birth or simply an increase in the tone of the uterus. It is also possible to determine the heartbeat of the fetus and assess how such pain affects the fetus.

The main thing in diagnosing such a process is comparing all the symptoms and excluding emergency conditions.

Differential diagnosis

Differential diagnosis should be carried out between all pathologies that are accompanied by similar pain.

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Treatment lower abdominal pulling pain in pregnancy

The main principle of treatment of such pathology is etiological. Therefore, medications used for such pathologies should be prescribed only when the cause is determined.

1. If the cause of the nagging pain is a threat of miscarriage, then they try to save the pregnancy with the help of tocolytic therapy. If a miscarriage is in progress, then it will not be possible to save the pregnancy in the first trimester. As a tocolytic therapy, drugs are used that reduce the tone of the uterus.

Hexoprenaline is a drug from the group of selective sympathomimetics, which acts by binding to uterine receptors and leads to relaxation of muscle fibers. Therefore, the drug can be used to stop uncomplicated premature labor, which is accompanied by an increase in uterine tone and rhythmic contractions. The drug cannot be used at a pregnancy term earlier than 22 weeks. The method of administration of the drug is intravenous, which allows you to quickly achieve the effect. Dosage - 10 micrograms of the drug should be administered slowly, and then switch to infusion use. Side effects are palpitations, heart rhythm disturbances, headache, feeling of heat, increased pressure, tremor, diarrhea. Precautions - do not use the drug if the mother has congenital heart defects.

1. Utrozhestan is a hormonal drug used for further treatment of the threat of miscarriage. Hormonal imbalances are often the cause of the threat of premature birth, so progesterone therapy is mandatory after the symptoms have been eliminated. Utrozhestan contains progesterone, a natural hormone that stabilizes the activity of the uterine muscle fibers and reduces its tone. The drug helps to normalize fetal trophism and improves uteroplacental blood circulation. It helps to prolong pregnancy by increasing the level of natural progesterone. The dosage of the drug is determined individually. Method of administration - 100 or 200 milligrams per capsule every day or every other day. Side effects - dizziness, drowsiness, pain in the mammary gland, itching of the skin, vomiting, fluid retention with the formation of edema. Precautions - it is important to monitor the dosage of the drug and the effect of this dose.
2. If the cause of heaviness in the abdomen according to the exact data of the ultrasound examination is pyelonephritis, then it is necessary to use complex treatment, the main element of which is the restoration of urine outflow. In pregnant women, pyelonephritis is secondary due to the fact that the uterus compresses the ureters, therefore, a mandatory element of treatment is stenting with the restoration of urine outflow. Then it is necessary to prescribe an antibiotic that can be used by pregnant women. Such approved antibacterial agents include unprotected aminopenicillins and cephalosporins. If we are talking about an exacerbation of chronic adnexitis or oophoritis, then it is necessary to use an antibiotic in the treatment. Antipyretic and antispasmodic drugs can be added to the complex treatment.

Cefpodoxime is a third-generation beta-lactam antibiotic, especially effective against gram-positive and gram-negative flora bactericidal. The drug has a bactericidal effect on possible anaerobic pathogens of urinary tract infections, so it can also be used for cystitis. The dosage of the drug is 200 milligrams twice a day, for at least ten days. Side effects are possible when affecting the stomach - colitis or dysbacteriosis develops, which is manifested by bloating, stool disorders. Precautions - the drug cannot be used if you are allergic to penicillin antibiotics, as well as with congenital enzyme deficiencies.

1. Paraverine is a combination drug that includes the antipyretic agent paracetamol in a dose of 500 milligrams, as well as the antispasmodic drotaverine in a dose of 40 milligrams. This drug, due to its complex action, is able not only to reduce body temperature during inflammatory reactions, but also relieves headaches and increased uterine tone in pregnant women. The dosage of the drug is a 10-milligram tablet, which can be taken with an increase in temperature or headache with an interval of at least 40 minutes. It is not recommended to take more than three tablets per day. Side effects occur in the form of stomach pain, dizziness, decreased blood pressure. Precautions - do not use in combination with other drugs of the same group and take with caution in liver diseases.

Vitamins for pregnant women will be beneficial in any case, given the increased need for various microelements. When choosing a vitamin product, you should give preference to those preparations that contain not only vitamins, but also microelements.

Physiotherapeutic treatment of nagging pain in the lower abdomen can be widely used, for example, if there is a scar on the uterus that can cause such symptoms. Electrophoresis with papaverine and dimexide, as well as thermal procedures are used for this. It is necessary to undergo at least ten sessions if there are no undesirable effects of such treatment.

Folk remedies for nagging pain during pregnancy

Traditional treatment of this type of pathology during pregnancy can be used in case of threat of interruption or in case of normal miscarriages. In this case, various means and herbs are used that not only reduce the tone of the uterus, but also calm the woman's nervous system, relieve stress and improve blood circulation in the "mother-fetus" system.

1. To prolong pregnancy, use yarrow powder. To do this, take the dry leaves of this plant, grind them in a mortar to powder and take a teaspoon of this powder in dry form in the morning every day for twenty-two weeks of pregnancy.
2. Calendula tincture is an excellent tocolytic agent, and besides, it also has the ability to reduce bleeding activity, so if there is a risk of miscarriage, you need to take medicine from this plant to further normalize hemostasis. To prepare a medicinal tea, you need to take calendula flowers and fruits, pour half a liter of water, and then, after it has been infused for twenty minutes, strain and drink. Dosage - about a liter of tea should be drunk per day, monitoring other fluids in the presence of edema.
3. Viburnum with sugar has a very good effect on the general condition of a woman, improves blood circulation in the placenta and has antioxidant and immunomodulatory properties. For this, it is enough to take viburnum mashed with sugar throughout the pregnancy, especially in the first trimester. This is also an additional source of vitamin C.

The use of herbs and herbal teas also helps to normalize the tone of the uterus and calm increased nervous excitability.

1. To prepare the medicinal tea, you need to take 50 grams of stinging nettle and the same amount of erysipelas, boil it over low heat for five to ten minutes and then strain. You need to drink this tea three times a day, half a cup at a time, after which you need to lie down for a while, as dizziness may occur due to a decrease in pressure. This is not a side effect, but on the contrary, the complex action of the two plants helps to increase blood flow in the placenta area.
2. You need to take 100 grams of cinquefoil and marigold, make tea from a liter of water and drink in small sips throughout the day. The course of treatment is four weeks after the manifestation of nagging pain, then all processes should normalize and the symptoms will pass.
3. Licorice root, elecampane root and orthilia secunda leaves should be poured with dill and boiled for fifteen minutes. Then add currant berries and let the infusion cool. After half an hour, this tea can be drunk up to five times a day.

Homeopathy in the treatment of threatened miscarriage has its advantages, since the remedy is selected individually and the dose is always adjusted. In addition, long-term use of such homeopathic drugs is possible even before pregnancy.

1. Sabina is a homeopathic medicine used for abdominal pain of a pulling nature, especially when it radiates to the pubic area and bladder. It is available in the form of drops and is used in a dosage of eight drops per dose. Directions for use: drip the solution into 100 milliliters of boiled water and drink half an hour before meals. The course of treatment can be started before pregnancy with a dose of three drops, and then take eight drops during the first trimester. Precautions: it is not recommended to use the drug in obese women with arterial hypertension or gestosis. Side effects are rare, allergic skin reactions are possible.
2. Actea racquemosa is a homeopathic remedy consisting of herbal preparations that are more effective in patients with pain that is localized on one side of the abdomen or migrates from one side to the other, causing weakness and asthenia. The method of administration of the drug is three drops three times a day, under the control of the heartbeat - if tachycardia occurs, the dose can be reduced. No side effects have been identified. Precautions - do not take if allergic to plant pollen.
3. Hydrastis is a homeopathic remedy based on the plant goldenseal, which is very effective in maintaining pregnancy due to its action, which is similar to the natural hormone progesterone. The drug reduces the tone of the uterus and normalizes blood circulation, preventing spontaneous contractions. The drug is especially effective in the presence of early gestosis, which is accompanied by nausea and constipation. The drug is available in granules and is dosed at six granules every six hours. Taking the drug before pregnancy is not recommended.
4. Plumbum is a homeopathic preparation from the group of inorganic preparations. It is used to treat miscarriage with severe spasmodic abdominal pain. The method of using the preparation depends on the form. The dosage for drops is one drop per year of life, and for capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of the hands and feet, as well as a feeling of heat. Precautions - do not use if the body temperature rises.

Surgical treatment of pathology, which is accompanied by a nagging pain in the abdomen, unfortunately, is used in miscarriage, which does not allow to save the life of the child. In this case, in case of opening of the uterine os to a significant size, when conservative treatment is ineffective, it is necessary to stop the bleeding surgically. Then resort to surgical removal of the ovum by scraping out the uterine cavity. In the case of premature birth, which does not respond to tocolytic therapy or there are indications from the fetus, surgical intervention is also performed - cesarean section. If the pain in the abdomen is caused by placental abruption, then this is an indication for surgical treatment, sometimes it is necessary to remove the uterus if the hematoma is large.

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Prevention

Prevention of nagging pain in the lower abdomen during pregnancy can be non-specific and it consists of normalizing the pregnant woman's regimen and nutrition. A woman should not have heavy physical exertion, rest during the day should be at least two hours, and sleep - at least eight. Nutrition should take into account the needs of the woman, with the calculation of sufficient consumption of kilocalories and vitamins.

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Forecast

The prognosis for the development of complications with nagging pain can be favorable for normal pregnancy if you seek help in a timely manner.

If you have a pulling pain in your lower abdomen during pregnancy, it may not necessarily be a serious pathology, but you should not miss this symptom, since any changes in the body of a pregnant woman affect the child. You should definitely tell your doctor about such pain, and he will look for the cause. In any case, if you are afraid for your health and the health of your baby, you need to get examined and find out the cause.

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