Stomach aches during pregnancy: is it normal — the doctor answers

In the heading «Ask an expert a question», our reader, 34-year-old Julia, asks:

«I’m expecting a baby, it’s the second trimester. Recently, I began to have pulling pains in the lower abdomen, which are periodically repeated. What could it be, and is it worth worrying about?»

From 5-6 weeks of pregnancy until the very birth, the expectant mother may experience periodic weak pulling pains in the lower abdomen. Usually they do not cause severe discomfort and do not interfere with doing everyday things. Usually they are localized in the pubic area, but it can also stretch the lower back.

The reason for these pains is that, as the uterus gradually grows, the ligaments with which it is attached to the abdominal cavity stretch. This causes unpleasant sensations. The same thing happens with the muscles of the anterior abdominal wall, pelvic floor and perineum.

Such pains do not require treatment. One piece of advice can be given: to do gymnastics more often to prevent «stagnation» in the muscles.

But it is better to inform the doctor about these pains anyway, in order to exclude a serious risk. The fact is that under the same mask, sometimes there is an increased tone of the uterus, and it already threatens to terminate pregnancy. Ultrasound of the uterus, vaginal examination and palpation of the abdomen helps to identify increased uterine tone.

What else can lower abdominal pain mean during pregnancy
Premature placental abruption
If the pain in the lower abdomen is cutting, accompanied by bloody discharge, dizziness, attacks of sudden weakness, this may signal a formidable complication of pregnancy. Then the expectant mother will need urgent hospitalization. Treatment will depend on the area of the lesion and the strength of the bleeding. With partial detachment, doctors usually prescribe strict bed rest, hemostatic drugs and antispasmodics. In more severe situations, an emergency caesarean section may be required.

Adhesions in the abdominal cavity
Mild pain in the abdomen or groin area may occur due to adhesions. This problem is faced by women who have had any abdominal surgery during pregnancy. The uterus may be «welded» by adhesions resulting from healing to the intestines, ovaries, and walls of the abdominal cavity. As the uterus grows, these adhesions stretch, causing some pain.

Sometimes to solve a problem (for example, if adhesive intestinal obstruction develops), the help of a surgeon is required, but in most cases you just have to put up with these symptoms.

Urinary tract infections
If frequent urination, pain during urination, back pain are added to the pain in the lower abdomen, then they may indicate urolithiasis, pyelonephritis or exacerbation of chronic cystitis. Under the influence of hormones in pregnant women, the acidity indicators (pH level) in the vagina often change, which is why its microflora is disturbed. Harmful bacteria in such an environment begin to multiply actively. In addition, during pregnancy, the load on the kidneys increases, so they also come under attack.

To accurately diagnose, you will need a urine test, ultrasound of the bladder and kidneys. Exacerbations of urinary tract infections are treated with antibiotics. It is impossible to refuse them, otherwise the kidneys may fail. However, in the beginning, the expectant mother is usually offered more gentle methods: diuretic teas, herbal medicines and copious drinking.

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