Pain in late pregnancy

As the long-awaited moment of meeting the baby approaches, the body can prepare the pregnant woman for the birth process using "pain training". Of course, not everyone experiences pain in the later stages of pregnancy. The growth of the fetus in the last months causes barely noticeable unpleasant sensations, but for some expectant mothers, discomfort develops into severe pain syndromes.

Tension and hardening of the peritoneal wall foretells an imminent resolution of pregnancy. Such a change is more often observed during physical exertion, a state of orgasm, in a sad or angry mood. If the abdominal tissues soften again, then there is no reason to worry.

Pain in late pregnancy may signal a pathology and threaten spontaneous termination of pregnancy (there is a shortening of the cervix with simultaneous opening of its os).

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Causes of pain in late pregnancy

Factors that cause pain in late pregnancy:

• an incorrect diet, which is accompanied by spasms in the digestive system and provokes the appearance of pain. A pregnant woman should eat fresh products and not overeat. The organs of the digestive tract work in an increased mode, squeezed by the enlarging uterus. Intestinal motility slows down, which causes constipation. Therefore, it is important to drink enough fluids, eat raw fiber and move more;
• stretching of the ligamentous apparatus supporting the uterus. The pain is quite sharp, but not long-lasting, and intensifies with movement;
• tension of the abdominal muscle corset responds with pain during physical exertion. Relaxation and rest will help cope with the pain syndrome;
• exacerbation of diseases - pancreatitis, inflammation of the appendix, intestinal obstruction. Rare diseases in pregnancy occur against the background of severe pain accompanied by dizziness, nausea, fever;
• gynecological pain is the result of pathology, deterioration of the pregnant woman’s condition;
• Spontaneous termination of pregnancy - accompanied by aching pain, reminiscent of contractions and radiating to the lumbar region. The process develops with vaginal discharge and requires immediate medical attention;
• placental abruption – as a result of abdominal trauma, overexertion, due to various diseases (for example, hypertension). The pain syndrome is concentrated in the lower abdomen. Damage to blood vessels leads to hemorrhage in the uterus, as well as a threat to the life of the mother and child.

Doctors hear complaints about discomfort in the lower back from half of pregnant women. Causes of pain in the lumbar region in late pregnancy:

• increased load on the spinal column due to the growth of the fetus, starting from the 5th month. The pain may radiate to the leg, intensify after exertion, prolonged sitting/standing position;
• neuralgic diseases - intervertebral hernias, radiculitis. A bandage, rest, and therapeutic exercises will help alleviate the condition;
• symphysiopathy - a hereditary predisposition that causes stretching and softening of the pubic area with hemorrhage. Pain in the pubic symphysis is often long-term and is accompanied by a change in gait;
• kidney diseases are characterized by pain in the lumbar region, fever, severe swelling, headache and high blood pressure, frequent urination with cloudy urine. Kidney treatment (for example, pyelonephritis) is carried out in a hospital setting;
• urolithiasis - it is indicated by intense colic in the lumbar region of a sharp, cramping type, often with a violation of urination;
• preparatory contractions (Braxton-Hicks) – felt as varying degrees of uterine tension and pain in the lower back.

Pain syndrome is often observed during hormonal changes in the body, causing arthralgia (joint pain) in the later stages. An unstable emotional state can also be the cause of painful sensations. Pregnancy is often accompanied by stress, anxiety, and nervous overload.

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Symptoms of pain in late pregnancy

The obstetric nature of pain in late pregnancy is associated with the possibility of miscarriage. Such situations have, firstly, an initial predisposition - chronic diseases of the pregnant woman, hormonal imbalances, pathologies of fetal development. Secondly, the symptoms of spontaneous termination of pregnancy are distinguished by lumbar pain with the presence of contractions, the strength and frequency of which increases over time.

Non-obstetric symptoms of pain in late pregnancy include:

• heaviness, a bursting sensation, pain in the hypochondrium on the right - characterize dyskinesia of the gallbladder and its ducts. Dyskinesia often leads to inflammation and the formation of stones. In turn, cholelithiasis and chronic cholecystitis provoke the development of dyskinesia;
• high blood pressure, swelling, headache, protein in the urine are signs of preeclampsia (a form of late toxicosis). It can develop into eclampsia (the appearance of convulsions), which threatens the life of the mother and child;
• discomfort and density of tissues in the abdominal area indicate dropsy;
• a feeling of heaviness in the legs – caused by weight gain or fatigue, varicose veins;
• joint pain – often caused by progesterone, which softens the ligaments;
• heartburn and pain in the intestines – the cause may be gastritis, banal overeating;
• acute pain localized on one side is an alarm signal requiring medical attention. Severe pain syndromes that do not go away for a long time accompany appendicitis, intestinal obstruction or pancreatitis;
• severe attacks of pain in the upper abdomen, of a girdle-like nature – indicate problems with the pancreas. Nausea/vomiting, problems with defecation, and low blood pressure are often observed.

Diagnosis of pain in late pregnancy

An experienced gynecologist can establish the exact cause of the pain syndrome. During the appointment, the doctor collects anamnesis based on the patient's complaints. A number of conditions require a gynecological examination and taking a smear for analysis. For example, diagnostics of pain in late pregnancy with bleeding. In case of vaginal discharge, a blood test for biochemistry, HIV, testing for hepatitis and syphilis, as well as a coagulogram (blood clotting) and general urine analysis may be required.

The most reliable method remains ultrasound, with the help of which doctors differentiate disorders of the pancreas, kidney diseases, the condition of the uterus and fetus, etc.

Additional examination methods include MRI and FGDS (fibrogastroduodenoscopy).

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Treatment of pain in late pregnancy

The therapeutic effect is prescribed by the attending physician depending on the existing pathology and the stage of development of the disease.

The therapeutic effect of inflammatory disease of the pancreas (pancreatitis) is achieved in a hospital using a conservative approach, namely: a strict diet, taking medications to improve the functioning of the gland, using painkillers and anti-inflammatory drugs. Some cases require surgical intervention.

Renal colic is relieved by antispasmodics and painkillers. Small stones can come out on their own, but blockage of the ureter lumen by large elements does not exclude surgical treatment.

Treatment of pain in late pregnancy with a threat of miscarriage is aimed at preserving the life of the baby. Conditions aggravated by bleeding are constantly monitored by a gynecologist. If the ultrasound has confirmed the viability of the fetus, then antispasmodics are used, magnesium drips are given, and vitamins are administered.

In connection with the suspicion of placental abruption, a cesarean section is performed. Cases with heavy bleeding require an emergency cesarean section, regardless of whether the fetus is full-term or premature.

How to prevent pain in late pregnancy?

Preventive measures for discomfort in the lower back:

• rational nutrition – eat foods with high calcium content (greens, dairy products, fish). You can drink calcium lactate/carbonate;
• watch the load on your back - do not lean forward if you need to pick something up from the floor, squat down (the muscles of the legs and shoulder area work, the back is not involved). Sit down carefully, do not plop down with a running start, take care of your discs. Sit in a comfortable position with support on the back of the chair. Give preference to an orthopedic mattress and a comfortable pillow;
• wear comfortable shoes;
• Don't forget to strengthen your back, stomach, and hip muscles. Aqua aerobics and swimming give particularly good results.

Prevention of pain in late pregnancy with a predisposition to intestinal disorders includes monitoring the amount of food consumed and its composition. It is undesirable to overeat, which negatively affects your weight and the digestion process in conditions of reduced intestinal motility. To get rid of frequent constipation, increase fluid intake, introduce fiber into the diet (vegetables, fruits, whole grain bread). Do not forget to walk more in the fresh air and think only positively.

Late Pregnancy Pain Prognosis

A lot of worries for the expectant mother are caused by pain in the late stages of pregnancy, which should be treated carefully, but without panic. Pain syndrome and the appearance of contractions prepare your body for the upcoming joyful event. The reason for contacting a gynecologist may be increasing, frequent and cramping pain with spotting or bloody discharge.

Pain caused by constipation, intestinal problems, very often occur due to the fault of the woman herself, who does not know the measure in food and is used to living by the principle of "eating for two". In the last months of pregnancy, you need to be very careful about the choice of food, which should be fresh and natural, as well as the volumes consumed. Eat more often and fractionally, use a decoction of dried apricots/prunes for natural laxation.

Of course, the expectant mother should rest more, especially in a position with her legs up, but she should also not forget about moderate physical activity.

The prognosis of pain in late pregnancy, confirmed by diagnostic examination, in case of pathologies of internal organs may not be comforting. Acute, chronic processes often require surgical intervention. However, it should be taken into account that all actions of doctors are aimed at preserving the life of the mother and child.

The expectant mother should not panic when pain appears in the late stages of pregnancy, but should contact a specialist in a timely manner. Most often, unpleasant sensations as labor approaches are natural under the influence of hormones and a growing belly.