Heartburn And Acid Reflux
Aside from constipation, the production of progesterone, the hormone that relaxes muscles in preparation for labour and birth, during pregnancy can cause heartburn, indigestion and acid reflux in pregnant women. Progesterone causes the valve at the top of the stomach to relax and so allows gastric acid to escape up the oesophagus, which can cause discomfort. This problem occurs particularly at night when lying in bed. Heartburn, indigestion and acid reflux can all begin in the first trimester but usually become more of a problem in the third trimester when the size of your baby is also pushing against your stomach. If youre having difficulty sleeping at night because of these conditions, try allowing two or three hours after eating before you go to bed to allow digestion to occur, and sleep on a couple of pillows so that your stomach is lower than your head.
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Case & Commentarypart 2
The patient again returned to the ED within 24 hours with persistent complaints. She now appeared more ill, with increased abdominal pain on examination. Magnetic resonance imaging of the abdomen was performed and revealed a ruptured appendix with signs of peritoneal inflammation. The patient was taken immediately to the operating room and was found to have diffuse peritonitis secondary to the ruptured appendix. An emergent laparoscopic appendectomy was performed, which the patient tolerated well. Unfortunately, 3 hours after the operation, she had a spontaneous abortion and subsequent severe bleeding requiring multiple transfusions. She was discharged home days later.
In retrospect, it may not have been appropriate to discharge this patient from the ED after her initial presentation without further evaluation, and she experienced a tragic adverse event.
In the above case, in the initial visit, pregnancy location and gestational age should have been documented, and a further investigation into the patient’s signs and symptoms should have prompted imaging of the abdomen and pelvis and consultation with an obstetric specialist. When the patient returned with worsening symptoms, appropriate imaging was pursued and revealed acute appendicitis. The error led to a catastrophic adverse eventthe loss of the fetus. A checklist highlighting the warning signs above or an algorithm for early and safe imaging may have led to an earlier diagnosis and a better outcome.
Take-Home Points
Braxton Hicks Contractions And Left Side Abdominal Pain During Pregnancy
Braxton Hicks contractions are one reason for left side pain during pregnancy in the third trimester.
Many pregnant women easily mistake these uncomfortable cramping aches as the start of labor. According to Dr. Melissa Conrad Stöppler on MedicineNet, Braxton Hicks contractions are harmless causes of pregnancy pain. The painful contractions occur in the uterus at irregular intervals and will cause your groin to feel tight.5
The abdominal pain caused by Braxton Hicks contractions is sometimes referred to as false labor.
You can tell Braxton Hicks contractions apart from the start of labor by the type and intensity of the squeezing uterus pain. For example, unlike labor pains, Braxton Hicks contractions are not as sore and dont become more intense over time. Also, Braxton Hicks contractions dont come at regular intervals.
You may find that towards the end of pregnancy, Braxton Hicks contractions become more frequent. The American Pregnancy Association reports that touching the abdomen, having a full bladder, being dehydrated, or being active can trigger Braxton Hicks contractions. Sometimes, taking a warm bath or having a few glasses of water are enough to get relief from the cramping pains in late pregnancy.6
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If You Feel Any Of These Pregnancy Pains You Should Give Your Doctor A Call:
This could signal appendicitis . Surprisingly, besides pregnancy complications, appendicitis is the most common reason for emergency surgery during pregnancy, Dr. Clark tells SELF. Around 0.1% of pregnant people will experience appendicitis during pregnancy, and its most common in the second trimester, according to the Mayo Clinic. The pain may be sudden and may be sharp or dull and achy, says Dr. Clark. It is typically associated with fever, inability to eat, nausea, and vomiting. See your doctor right away if youre in pain and suspect something is wrong.
It can be difficult to diagnose appendicitis , but if your doctor understands your history and conducts a thorough examination, its a very treatable condition, the Mayo Clinic says. First, doctors will perform a series of tests and scans to confirm that you have appendicitis, SELF previously reported. From there, they might determine whether surgery is the best option. In cases where your provider decides that surgery isnt right for you, they might prescribe antibiotics to treat infection and remove your appendix at a later time.
Another possible cause is miscarriage, which means losing a pregnancy before the 20th week . Sadly, 10 to 20% of known pregnancies end in miscarriage, according to the Mayo Clinic, but the actual numbers might be higher because many people might have a miscarriage without knowing theyre pregnant. Sharp, dull, or cramping abdominal or lower back pain paired with bleeding is a red flag.
When Should I Report Stomach Pain In Pregnancy
Stomach pain can be very worrying for pregnant women. Pain can make you fear the worst, such as a miscarriage. Its important to listen to your own instincts. If you are worried about any pains youre having, or you just feel like something is wrong, contact your midwife. Dont be concerned about wasting anyones time. Its always best to get things checked out.
If you are having persistent stomach pain or cramping, or if the pain comes on suddenly it should be checked by a doctor or midwife immediately.
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Warning Symptoms And Signs
Although sharp pain may be caused by normal pregnancy-related changes, there exist certain warning signs you should be on the lookout for, in case this sharp pain you are experiencing is because of a complication. They include:
- Pain accompanied by change in vaginal discharge, vomiting, heavy bleeding, chills, or fever
- If you experience sharp continual pain after adjusting or resting
- If this stomach pain makes it difficult for you to speak, breathe, or walk
When Do You Start Cramping In Your Stomach During Pregnancy
In layman’s words, the type of discomfort you’ll feel in your stomach or lower abdomen is classified as: Some women have mild cramps at the beginning of their pregnancy, which may or may not be followed by spotting . This usually occurs around the estimated time of the period, or a few days earlier.
Request that your doctor test your blood for anemia on a regular basis. When you’re pregnant, it’s natural to have an unsettled stomach. Put it down to pregnancy’s hormonal changes. It commonly occurs early in pregnancy, as your body adjusts to the increased hormone levels.
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Figuring Out Your Due Date
Your doctor will typically use the first day of your last period to calculate your due date by adding 40 weeks to that date.
This only works if you have normal menstrual cycles, though. It assumes that you conceived 14 days after your last period started. If your cycles are shorter or longer than the average 28 days, you might not have conceived around day 14 of your cycle. In that case, the calculated due date will be inaccurate.
If you know precisely when you conceived and it wasnt around day 14, you can talk to your doctor about adjusting your due date. However, they may not feel its necessary unless you have reason to think the numbers are way off.
If you know your cycles skew closer to 35 or 40 days, your doctor may order an early ultrasound to more accurately date your pregnancy.
Remember, even if you didnt conceive exactly on day 14, as long as your cycles are average length, your due date will be close enough its only an estimate, anyway!
What Causes Abdominal Pain During Pregnancy
More often than not, abdominal pain during pregnancy is perfectly normal and caused by the changes your body undergoes as part of gestation.
If youre a first-time mom, youll understandably be a bit warier of stomach pain, and you may want to consult your doctor. If so, make a note of the type of stomach pain youre experiencing. The more accurately you describe these feelings of discomfort, the easier itll be for them to pinpoint the cause.
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How Can I Tell Where The Baby Is
From that first hard spot on your abdomen, to new flutters and kicks, then dramatic bulges and bumps you might start to feel like your body is host to a strange unknown creature.
Some new parents find this thrilling. Others find it quite disconcerting and even unwelcome. All of these are normal reactions to the huge life transformation that is happening.
No matter how youre feeling about it all, each bump and movement is an invitation to become better acquainted with your new baby.
A great way of getting to know your baby is to understand what those bulges mean in relation to your babys position.
Spinning Babies, founded by midwife Gail Tully, is a great resource for learning where your baby lies in your womb.
In a technique called Belly Mapping, Spinning Babies experts provide suggestions for how to determine whether the bump youre feeling is a head or a bum, an elbow or a knee.
The first step of Belly Mapping involves sitting in a semi-reclined position for a few evenings in a row, while paying special attention to your babys movements and wiggles.
This will clue you in as to whether the baby is head down or head up, and facing your front or your back.
When youve figured out the babys major position, you can better identify what is a foot or a hand, and so on.
Dont be afraid to push, prod, and feel around on your belly for body parts. Baby is protected by the layers of your uterus and by amniotic fluid.
Big strong pushes come from feet and legs.
When Will You Experience Pregnancy Symptoms
One factor to consider is the fact that many of the earliest signs of pregnancy are the same symptoms you might have right before your period.
With that in mind, you probably won’t experience significant symptoms before your missed period. Most classic pregnancy symptoms dont start until one or two weeks after conception at the very earliest. Many women dont notice anything until one or two weeks after their missed period .
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General Abdominal Pain In Pregnancy
If you are having general pain in the abdomen but not specifically in the stomach, it could be due to a benign cause or it could be of concern. Your abdomen is growing and your organs are shifting, so some dull pain and an occasional sharp jab are normal.
The usual causes are:
- Braxton Hicks contractions: Often without pain, Braxton Hicks may cause discomfort or pain during the second and third trimester when experiencing these “practice” contractions.
- Cramping: Cramps may be felt due to the expansion of the uterus. These are usually not severe and subside after a few minutes of rest.
- Gas, bloating, or constipation: These symptoms are common due to the high levels of the hormone progesterone during pregnancy, which slows down digestion.
- Round ligament pain: You may feel this in the second trimester as the ligament that runs from your uterus to your groin is stretched. This can be a sharp stabbing pain when you make a change in position or it can be a dull, achy pain.
Causes Of Cramping In Early Pregnancy
It is common to experience mild pain or cramps in your abdomen during pregnancy. In most cases, abdominal pain in early pregnancy is caused by normal bodily changes such as:
- Implantation When a fertilized egg forms a blastocyst and implants into the lining of the uterine wall, it can cause a bit of cramping in your lower abdomen. This is known as implantation cramping and is often one of the first signs of pregnancy.
- Uterine growth During the first two trimesters, there is rapid uterine growth to accommodate the growing fetus. This can also lead to early pregnancy cramping. As the ligaments and muscles that support the uterus also grow, you might experience sharp pain when you stand, change position, or sneeze/cough.
- Orgasm If you have sex while pregnant, you may experience cramps after an orgasm. The pain may feel similar to a period cramp and usually goes away quickly. This doesnt mean that you have to stop having sex if youre pregnant, though. That being said, if the pain is severe and accompanied by bleeding, consult with your health care provider immediately.
In rare cases, early pregnancy cramps may be caused by the following pregnancy problems:
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Can Morning Sickness Start At 1 Week
Pregnancy symptoms in week 1
According to the Office on Womens Health, the most common first sign of pregnancy is a missed menstrual period. Other early pregnancy symptoms include: nausea with or without vomiting. breast changes including tenderness, swelling, or tingling feeling, or noticeable blue veins.
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Does Your Lower Abdomen Feel Hard When You Are Pregnant
When youre pregnant, you should expect a firm stomach. The pressure of your uterus developing and placing strain on your abdomen is causing your hard-feeling stomach. If you eat a low-fiber diet or consume a lot of carbonated beverages while pregnant, the hardness of your stomach may become more evident.
Your abdominal muscles will continue to grow throughout pregnancy, so even if you already have a flat stomach, youll want to work out regularly to keep them tight.
These exercises can help tone your stomach:
1. Barbell hip thrusts strengthen your upper body while building strong abs. Stand with your feet shoulder width apart and hold a barbell with both hands directly above your shoulders. In one motion, lift your hips so that your knees are bent 90 degrees and your thighs are parallel to the ground, then push your hips forward until theyre nearly touching the back of your heels. Repeat for as many reps as possible.
2. Crunches work the abdominal muscles on the front of your torso. Start by lying face up on the floor, arms at your sides. With your head lifted, bend your elbows and pull your shoulders down toward your ears. Lift your head, neck, and chest off the floor in this position. Then release the tension in your shoulders and roll back over onto your left side. Repeat on the right side.
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Case & Commentarypart 1
A 34-year-old woman who was 14 weeks pregnant presented to the emergency department with 5 days of nonspecific abdominal pain, nausea, and vomiting. On examination, she appeared well with normal vital signs and had some mild diffuse abdominal tenderness. Her white blood cell count was 19,000 cells/L, and a urinalysis was positive for nitrates and leukocyte esterase . She was diagnosed with a urinary tract infection and was discharged on antibiotic therapy. No imaging was performed at this initial visit.
The patient returned the following day with unchanged abdominal pain and more nausea and vomiting. A fetal ultrasound was performed and found normal fetal heart activity. No further testing was done, and she was discharged home with instructions to continue the antibiotics.
Abdominal pain remains the most common reason for emergency department visits, comprising more than 11% of all visits in 2008. In 2011, 54% of patients that presented to the ED were female, more than 25% were of childbearing age, and the pregnancy rate in the United States is approximately 10% at any given time. For these reasons, clinicians that evaluate patients with abdominal pain in the ED should be familiar with common causes of abdominal pain in pregnant women and appreciate when nausea and vomiting in pregnancy is abnormal.
There Are A Few Things You Can Do To Minimize Pregnancy Pains
Even if you havent experienced major pregnancy pain yet, prioritizing your health and well-being can go a long way toward helping you minimize the aches and pains you might encounter. Dr. Jones recommends staying hydrated and eating a well-balanced diet to support your overall health during pregnancy. Additionally, a little exercise can help with minor abdominal pains from constipation and gas, along with benefitting your mood and possibly even leading to better overall pregnancy outcomes like postpartum recovery time, the ACOG explains.
If you are dealing with major abdominal pain during pregnancy, it can be hard to figure out how best to minimize it because there are so many potential causes. What is clear is that you should talk to your doctor about any discomfort you have before setting out to treat it yourself, especially if your self-treatment plans include over-the-counter medications. More importantly, its difficult to determine serious symptoms from minor signsand time is a factor when it comes to more serious conditions like preeclampsia and preterm labor. Early detection is also key. If you arent feeling quite right and symptoms seem to be getting progressively worse, notify your doctor straight away, Dr. Jones says.
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Are Cramps During Pregnancy Normal
Some abdominal cramping and stomach pain in pregnancy is common. Early pregnancy cramps can be linked to many run-of-the-mill pregnancy symptoms, including constipation or increased blood flow to the uterus.
Later on in pregnancy, pregnancy pains could be linked to normal symptoms like Braxton Hicks contractions or round ligament pain.
Sometimes, however, abdominal pain during pregnancy can be a sign of a condition that requires medical attention, like a urinary tract infection, miscarriage, preterm labor or preeclampsia. Its always safest to about any symptom that concerns you.
The following are common causes of abdominal pain and cramps during pregnancy that can occur during any trimester:
