Why pulls the lower abdomen during pregnancy and what should I do?

With the pulling sensations in the lower abdomen during pregnancy, every second woman encounters. Often this is a vain anxiety, but do not forget about the pathological conditions that can cause such a symptom. To protect your life and the health of your unborn child, you need to clearly know the main pathologies that can cause such pain.

Epidemiology

The epidemiology of this problem for etiologic 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 carry 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 these symptoms get to the hospital on time, which threatens the termination of pregnancy. In 80% of women, the traumatic pain caused by a serious illness is accompanied by other symptoms, which proves the need for complete diagnosis and knowledge of these additional clinical manifestations.

[1], [2], [3], [4], [5]

Causes of the pulling pain in the abdomen during pregnancy

The reasons for drawing pains in the abdomen during pregnancy can be quite a lot, but it is important not only to know about them all, but also to understand where that line is, when this is already an abnormal phenomenon and it is necessary to seek advice. It is very important and the duration of pregnancy, because depending on this and there are those or other violations that entail such pain.

Before you understand the reasons, you need to talk about the risk factors for this pathology. In women who become mothers for the first time, the risk of developing such symptoms is higher only because both the uterus and all the muscles of the abdominal and pelvic floor are not ready for such a load. Uterus with an increase in the duration of pregnancy is stretched, and since this is a muscular organ, only this can cause such feelings. Together with the uterus, the muscles of the abdomen are stretched too - this leads to lengthening of the muscle fibers, which is why the pain can be felt. These phenomena are normal and can be for every woman, but they do not carry any danger. The question is only to determine the pathological condition, when it is already worth intervening. Among such conditions, it is necessary to distinguish inflammatory diseases of the internal genital organs. Women who had a history of chronic adnexitis or cyst, or another focus of infection have very high risk factors for complications in pregnancy, and one of the manifestations of such complications may be just such a feeling in the lower abdomen. In this case, such a symptom can often indicate an exacerbation of the disease. Therefore, one of the reasons that during pregnancy pulls the lower abdomen, there may be an infectious inflammation of the tubes or ovaries. The pathogenesis of the clinical picture is that the infectious process has spread to neighboring structures - it irritates the pain receptors of the peritoneum covering the uterus or the ovaries, which causes drawing pain. But it should be noted that the inflammatory process can not always have a strong manifestation, and the symptomatology can be sluggish - that in addition to drawing pain can not cause other symptoms.

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

A very important reason for the pulling pain in the lower abdomen is an ectopic pregnancy. Under normal conditions, on the seventh day after the fertilization of the egg, the embryo moves along the fallopian tube and is implanted into the uterine cavity, where it subsequently develops. When for certain reasons the embryo can not reach the uterus, it is implanted in the tube or leaves it and falls on the ovary or in the abdominal cavity, this is an ectopic pregnancy. Over time, the embryo grows and places become scarce, which leads to a stretching of the tube and the appearance of symptoms. And the first symptom is most often a drawing pain in the abdomen.

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

Late gestation may carry a potential hazard in the form of a placenta detachment, and this condition is often accompanied by traumatic pain. But there are other symptoms, so do not focus only on pains to diagnose this condition in time.

At any time of pregnancy, the manifestation of acute pathology of the urinary tract can be such a pain. In this case, one should think about renal colic or acute gestational pyelonephritis. Thorough differential diagnosis is simply necessary for proper treatment.

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

[6]

Symptoms of the pulling pain in the abdomen during pregnancy

If the pain is caused only by stretching the muscles of the press and the uterine fibers, then the clinical picture is limited only by the periodic sensation of gravity in the lower abdomen, as in the case of menstruation. As the gestation period increases, these feelings can increase. But this is the only symptom in this case, which appears from time to time and unstable. He does not violate the general condition of women and does not entail any problems.

If, in addition to the pulling 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 be activated, then there is pain, as well as a rise in temperature, which is inherent in any inflammatory process. The very increase in temperature and signs of intoxication can already testify that it is serious. There may also be purulent discharge from the vagina, or simply unpleasant discharge or discomfort.

If pulling the lower abdomen in the first trimester of pregnancy, this may be a sign of a threat of premature interruption. In this case, only spastic pains in the lower abdomen are observed, which are repeated. If this is accompanied by bloody discharge, then it is already a miscarriage in progress, and then it will not be possible to save the child. That's why, in the case of such intense pain, it is necessary to contact the doctor at once, rather than wait for the symptoms to pass.

If you pull the lower abdomen in the second and third trimester, then the cause can be either premature birth or exfoliation of the placenta. The tactics are very different for all these pathologies. The first signs of premature birth are the same as in normal, that is, the pain in the lower abdomen. Sometimes, in the last weeks before giving birth, a woman can suddenly feel such a severity that she will not be accompanied by the discharge of water or the onset of labor. Then we are talking about a pathological preliminar period in which false fights do not lead to a normal opening of the cervix.

If the abdomen is strongly pulled during pregnancy and it is accompanied by bloody discharge already in later terms, then it is necessary to exclude the placenta detachment. But bloody discharge may not be, so you need to focus only on the intensity of pain.

When walking, pulls the lower abdomen during pregnancy more often because of physical exertion, then it is recommended to relax, and the symptoms must pass.

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

If you pull the lower abdomen with urination, then most likely it is the inflammation of the lower urinary tract. Cystitis is a common disease of pregnant women due to compression of the bladder. In addition, there is pain during urination, burning, frequent urination and frequent desires.

If you pull the lower abdomen and diarrhea during pregnancy, then you need to exclude food poisoning. This may be accompanied by symptoms of vomiting, nausea, which will lead to the thought of poisoning.

Thus, the pulling pain in the lower abdomen is only one symptom, and for a complete characterization of the state, it is necessary to evaluate others, in order to help in time.

Complications and consequences

The consequences of drawing pain depend on the cause and on the urgency of the care provided. When a threat of miscarriage can save a child, but if a 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 - chorionamionitis, congenital fetal pneumonia, congenital malformations. The consequence of untimely diagnosis of placental detachment may be a large retroplacental hematoma, which eventually leads to the need for removal of the uterus.

Complications that occur against the background of only one symptom - the severity of the lower abdomen - can be very serious, what you should know to prevent them, and not to treat.

[7], [8], [9], [10]

Diagnostics of the pulling pain in the abdomen during 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 to say that this is a normal phenomenon in pregnancy.

First you need to establish all the history data and clarify the duration of pregnancy, the nature of the pain, and how they are related to the load. Sometimes the fact that pains pass after rest can indicate their physiological character. It is important to clarify whether the nature of the secretions has changed and whether the body temperature has increased.

Analyzes should exclude a pathological condition, and therefore general analysis is sufficient for general diagnosis. A general blood test helps to eliminate the inflammatory process, otherwise, there will be a leukocytosis and a shift of the formula to the left. A general urine test helps to establish the function of the kidneys and urinary tract. Any increase in white blood cells or protein may indicate inflammation. Then the diagnosis can be confirmed and objectively - a positive symptom of Pasternatsky testifies to the benefit of pyelonephritis.

If there is a suspected abruption of the placenta or a threat of abortion, a vaginal examination is mandatory, which helps to establish the stage of the process. The degree of opening of the internal uterine pharynx during miscarriage testifies to the stage of abortion and whether to maintain the pregnancy or it will not be possible. With detachment of the placenta, external bleeding may not be, then you need to determine the amount of blood loss with the help of instrumental methods.

Ultrasound can accurately determine the condition of the fetus, the localization of the fetal egg and you can accurately exclude a particular condition. You can also assess the state of the kidneys and the presence of obstruction, that is, diagnose pyelonephritis and urolithiasis. At the late term of pregnancy, the main method for diagnosing the condition of the uterus and the baby is cardiotocography. This method allows you to establish the tone of the uterus, which plays a major role in the appearance of such pulling pain. And then you can judge about premature birth or just about increasing the tone of the uterus. You can also determine the fetal heart rate and assess how this pain affects the fetus.

The main thing in diagnosing this process is the comparison of all the symptoms and the exclusion of urgent conditions.

Differential diagnosis

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

[11], [12]

Treatment of the pulling pain in the abdomen during pregnancy

The main principle of treating such a pathology is etiologic. Therefore, the drugs that are used in such pathologies, should be appointed only when the cause is clarified.

1. If the cause of pain is a threat of miscarriage, then the pregnancy is attempted with tocolytic therapy. If a miscarriage is in progress - then you will not be able to save pregnancy in the first trimester. As tocolytic therapy use drugs that reduce the tone of the uterus.

Hexoprenaline is a drug from the group of selective sympathomimetics, which acts by binding to the receptors of the uterus and leads to a relaxation of the muscle fibers. Therefore, the drug can be used to stop uncomplicated premature births, which are accompanied by an increase in the tone of the uterus and rhythmic contractions. The medicine can not be used on the term of pregnancy earlier than 22 weeks. The method of application of the drug - intravenous, which allows you to quickly achieve an effect. Dosage - 10 micrograms of the drug must be injected slowly, and then switch to infusion. Side effects are palpitations, heart rhythm disturbances, headache, fever, increased pressure, tremors, diarrhea. Precautions - do not use the drug for congenital heart defects in the mother.

1. Utrozhestan is a hormonal drug that is used to further treat the threat of miscarriage. Often, hormonal disorders are the cause of the threat of premature birth, so progesterone therapy is mandatory after the elimination of symptoms. The structure of Utrozhestan includes progesterone - a natural hormone that stabilizes the activity of the muscular fibers of the uterus and reduces its tone. The drug contributes to the normalization of the trophic fetus and improves utero-placental circulation. It promotes the prolongation of pregnancy by increasing the level of natural progesterone. The dosage of the drug is determined individually. The way of application is 100 or 200 milligrams per capsule every day or every other day. Side effects - dizziness, drowsiness, pain in the mammary gland, skin itching, 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 the severity in the abdomen, according to the exact data of the ultrasound study, is pyelonephritis, then complex treatment is needed, the main element of which is the restoration of the outflow of urine. In pregnant women, pyelonephritis has a secondary nature because the uterus contracts the ureters, so an obligatory element of treatment is stenting with restoration of the outflow of urine. Then you need to prescribe an antibiotic that can be given to pregnant women. Such authorized antibacterial agents include unprotected aminopenicillins and cephalosporins. If it is an exacerbation of chronic adnexitis or oophoritis, then it is necessary to use antibiotic in treatment. To the complex treatment can add antipyretic and antispasmodic drugs.

Ceppodoxime is a beta-lactam antibiotic of the 3rd generation, especially effective when applied to gram-positive and gram-negative flora bactericidal. The drug has a bactericidal effect on possible anaerobic pathogens of urinary tract infection, so it can also be used for cystitis. Dosage of the drug - 200 milligrams twice a day, at least ten days. Side effects are possible with the influence on the stomach - develops colitis or dysbiosis, which manifests itself by bloating, a violation of the stool. Precautions - do not use the drug for allergies to antibiotics-penicillins, as well as for congenital fermentopathies.

1. Paraverin is a combined remedy, which includes antipyretic paracetamol in a dose of 500 milligrams, as well as spazmolitik drotaverin in a dose of 40 milligrams. This drug, because of its complex action, is able not only to reduce body temperature in inflammatory reactions, but also relieves headache and increased uterine tone in pregnant women. The dosage of the drug is a tablet of 10 milligrams, 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, depression of pressure. Precautions - do not use in combination with other medicines of the same group and take care with liver disease.

Vitamins for a pregnant woman in any case will benefit, given the increased need for different trace elements. When choosing a vitamin remedy, you should give preference to those drugs that have in their composition not only vitamins, but also trace elements.

Physiotherapeutic treatment of pulling pains in the lower abdomen can be widely used, for example, if there is a scar on the uterus that can cause similar symptoms. To do this, use electrophoresis with papaverine and dimexide, as well as thermal procedures. It is necessary to pass at least ten sessions, if there are no undesirable effects of such treatment.

Alternative treatment of drawing pain in pregnancy

Alternative treatment of this type of pathology during pregnancy can be used in case of threat of interruption or with usual miscarriages. At the same time, various means and herbs are used which not only reduce the tone of the uterus, but also soothe the nervous system of the woman, 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 a powder and take a teaspoon of this powder in dry form every morning for twenty-two weeks of pregnancy.
2. Tincture of calendula is an excellent tocolytic agent, and besides it also has the properties to reduce the activity of bleeding, therefore, when a miscarriage threatens to further normalize the hemostasis, one must take a medicine from this plant. To make medicinal tea you need to take the flowers and fruits of marigold, pour water in the volume of a half liter, and then after it tinges for twenty minutes, strain and drink. Dosage - about a liter of tea you need to drink a day, controlling another fluid in the presence of edema.
3. Kalina with sugar very well affects the general condition of a woman, improves blood circulation of the placenta and has antioxidant and immunomodulating properties. For this it is enough throughout the entire pregnancy, especially in the first trimester, to take the fennel with sugar. This is also an additional source of vitamin C.

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

1. To make medicinal tea, you need to take 50 grams of dioecious nettle and the same number of erysipelas, it should be boiled over a slow fire for five to ten minutes and then filtered. To drink such a tea you need three times a day for half a cup, after which you need to lie down a bit, because there may be dizziness due to a decrease in pressure. This is not a side effect, but on the contrary, the complex action of the two plants contributes to increased blood flow in the placenta.
2. You need to take 100 grams of herbs lapchatka and marigolds, make tea from a liter of water and drink in small sips throughout the day. The course of treatment is four weeks after the manifestations of traumatic pain, then all processes should normalize and the symptoms will pass.
3. The root of licorice, the root of elecampane and the leaves of the hog queen should be poured in a lump and cook for fifteen minutes. Then you need to add currant berries and let cool. After half an hour, you can drink this tea up to five times a day.

Homeopathy in the treatment of the threat of termination of pregnancy has its advantages, as the individual is selected individually and the dose is always correlated. In addition, long-term administration of such homeopathic preparations is possible before pregnancy.

1. Sabine is a homeopathic medicine that is used for pain in the abdomen of a pulling character, especially when they are irradiated to the pubic region and bladder. Issued in the form of drops and used in the dosage of eight drops at a time. Method of application - the solution should be dripped into 100 milliliters of boiled water and drunk half an hour before meals. The course of treatment can begin before pregnancy with a dose of three drops, and then during the first trimester take eight drops. Precautions - it is not recommended to use the drug in full women with hypertension or gestosis. Side effects are rare, allergic skin reactions are possible.
2. Actaea is a homeopathic remedy that consists of herbal preparations that are more effective in patients with pain that is located on one side of the abdomen or migrates from one side to the other, which causes weakness and asthenia. The method of applying the drug - three drops three times a day, under the control of the heartbeat - with the appearance of tachycardia, the dose can be reduced. There were no side effects. Precautions - do not take with allergies to pollen from plants.
3. Hydra - stice is a homeopathic remedy based on the yellow-root plant, which is very effective in preserving pregnancy due to its action, which is like 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 are accompanied by nausea and constipation. The drug is released in granules and doses six pellets every six hours. Taking the drug before pregnancy is not recommended.
4. Plumbum is a preparation of homeopathic origin from a group of inorganic preparations. Used to treat miscarriages with severe spasmodic pain in the abdomen. The way of using the drug depends on the form. Dosage in case of taking drops - one drop per year of life, and with capsules - two capsules three times a day. Side effects are possible in the form of hyperemia of the skin of hands and feet, as well as sensation of heat. Precautions - do not use when the body temperature rises.

Operative treatment of pathology, which is accompanied by a drawing pain in the abdomen, unfortunately is used for miscarriage in the course that does not allow to save the life of the child. In this case, in the case of opening the uterine throat to a considerable extent, when conservative treatment is ineffective, it is necessary to stop bleeding surgically. Then resort to an operative removal of a fetal egg by scraping out the uterine cavity. In the case where premature births that do not respond to tocolytic therapy or have indications from the fetus - also carry out surgery - a caesarean section. If the abdominal pain is caused by a placenta detachment, this is an indication for surgical treatment, sometimes it is necessary to remove the uterus if the hematoma is large.

[13], [14], [15]

Prevention

Prophylaxis of pulling pain in the abdomen during pregnancy can be nonspecific and it consists in the normalization of the regime of a pregnant woman, nutrition. A woman should not have a lot of physical exertion, a day's rest should be at least two hours, and a dream - at least eight. Nutrition should take into account the needs of women, with the calculation of sufficient intake of kilocalories and vitamins.

[16], [17], [18]

Forecast

The prognosis of the development of complications with dragging pain can be favorable for normal gestation, if you seek help in time.

If pulling the lower abdomen during pregnancy - this may not necessarily be a serious pathology, but do not miss this symptom, as any changes in the body of a pregnant woman affect the baby. It is necessary to say about such pain to the doctor, and he is already looking for the cause. In any case, if you are afraid for your health and the health of your baby, then you need to be examined and identify the cause.

[19], [20], [21]