Pain during pregnancy

introduction

Pregnancy ( synonym: pregnancy, gestation, latin: graviditatis ) is an absolute state of emergency for the woman's body, albeit a natural one.

Over a period of 9 months ( 288 days ), the fertilized egg cell matures towards the child.
The following article looks at the causes of pregnancy pain.

Pain in pregnancy - general

Pregnancies can be very different.
While some women spend most of their time free from complaining, others complain about a number of problems. These problems range from moderate nausea ( hyperemesis ) to high blood pressure ( hypertension ) and rib pain.

But what causes pain during pregnancy and what kind of pain is that anyway?

Pain can be caused by the ovaries, for example.

As the unborn child grows, the uterus expands. This can be painful.

Natural stomach ache during pregnancy

During pregnancy, abdominal pain can be quite physiological. Just consider once that the body is placed under very nice extreme conditions.
The unborn child grows over time and there is a mass in the abdomen. It compresses other organs and the uterus expands and adapts to the new conditions.
This stretching may be painful, it is a normal muscle pain.

The child also begins to kick and move for a while. This will make expectant mothers clearly, possibly makes the baby in a painful way to attract attention.

Such complaints can usually be alleviated by a gentle posture. The pregnant woman can put her feet up or lie on her side.
In addition, hot water bottles or warm baths help.

However, a doctor should be consulted for long-lasting or very severe pain. A burning sensation when urinating, bleeding or severe nausea are also alarming. These may be indications of more serious complications and require medical supervision.

pregnancy fibroids

Fibroids are benign tumors of the uterus.
They can be described as benign muscle tumors that develop in the muscular layer of the uterus ( myometrium ). They consist of smooth muscles.

About one in four women have at least one fibroid after the age of 30, and about 25% of these women have symptoms.

The presence of many fibroids and a thereby enlarged uterus is called the uterus myomatosus.

Fibroids can grow up to 20 cm and pretend to be pregnant.

Symptoms that cause fibroids include increased menstrual bleeding or bleeding, urgency, pain and constipation.

During pregnancy, fibroids may cause additional discomfort between the third and sixth month of pregnancy .
They can be the cause of severe pain, isolated in the area of ​​the fibroid.

This pain is caused by the fact that the tissue of the fibroid is destroyed by a lack of blood supply ( infarcted ). This is called red degeneration.
Very severe pain causes them especially when they stretch the peritoneum.

Increased hormone production during pregnancy can promote the growth of fibroids, resulting in complications associated with previously uncomplicated fibroids.

In rare cases, very large fibroids lying in the uterus at the bottom may require caesarean section ( sectio caesarea ). This is always the case when the location of the fibroid obstructs the birth canal.

In addition, intrauterine fibroids increase the likelihood of miscarriage or premature birth.
After a certain size of the fibroid premature labor can be triggered.
In addition, the child may get into an anomalous situation, such as the breech position.

In very rare cases, they cause bleeding or premature detachment of the placenta. For this, so-called subplacental fibroids are responsible.
Such fibroids may interfere with the implantation of the embryo due to their location and thus lead to ectopic pregnancies.

What can you do about it?
There are numerous therapies, ranging from conservative medicines to surgical procedures.

The type of therapy depends on the situation, the general condition of the woman, the complaints and of course the desire to have children.

In pregnant women care must be taken not to endanger the pregnancy.

In principle, however, untreated fibroids should be monitored at regular intervals.
Thus, the growth of the fibroid can be observed and complications are avoided early.

The breasts and nipples also change as a result of pregnancy and can lead to problems.

gestoses

The term gestosis generally refers to pregnancy-related illnesses of unknown cause.

One distinguishes over the course of time an early gestosis, which occurs in the first trimester ( the first three months of pregnancy ) of a late gestosis, which manifests itself in the last trimester.

An early gestosis is usually shown as hyperemesis gravidarum ( excessive vomiting when the stomach is empty during pregnancy ) and ptyalism ( increased salivation ).

The hyperemesis gravidarum usually ends in the 14th week of pregnancy .
The affected women complain of persistent nausea, vomiting, abdominal pain and drowsiness.

It is usually enough to take the pregnant women in hospital and supply them intravenously with liquid and electrolytes.
In case of persistent hyperemesis medication with antiemetics is used.

Late gestosis manifests itself as so-called pre-clampsia or eclampsia.
A pre-eclampsia is a hypertensive disease that causes high blood pressure ( hypertension ), protein in the urine ( proteinuria ) and water retention ( edema ). These are the guiding symptoms.

Those affected complain of dizziness, headaches and nausea.

Since the cause is not fully understood, one should be careful with a therapy.
The blood pressure of pregnant women must not be lowered by medication uncontrolled. There may be a life-threatening condition for the fetus, which eventually ends in a premature birth or an emergency caesarean section.

The blood pressure of the mother is lowered at constant values ​​of over 170/110 mmHg . However, care must be taken that the blood pressure does not drop below 140/90 mmHg .

Since 2009, however, early detection of preeclampsia by means of a blood test is possible.
Furthermore, there is the danger that an eclampsia develops in a late-gestosis.
Eclampsia is a seizure that requires constant monitoring of the expectant mother and fetus.

The seizures can be treated by medication with intravenously administered magnesium.
Here, however, it must be strictly ensured that the reflexes of the woman can be triggered well. Otherwise there is a risk of respiratory arrest.

Another important symptom of gestosis in general is pain in the right upper abdomen.
By no means can one conclude from unspecific pain in the abdomen on the presence of a gestosis.

Pelvic pain in pregnancy

During pregnancy, the woman's pelvis is exposed to great stress.
An estimated one in every 600 pregnant women suffers from a so-called symphyseal loosening during pregnancy. Symphyseal loosening is an extremely painful affair which causes pubic pains in pregnancy but also afterwards.

The symphysis represents the anterior connection between the two halves of the pelvis. This is a type of disc consisting of fibrocartilage. This articulated connection is called pubic symphysis ( Latin: symphysis pubica ).

The joint is reinforced by tight ligaments, which is why there is usually no great freedom of movement between the two halves of the pelvis.

The symphysis, however, reacts to hormonal influences. During pregnancy, estrogens act on the fibrocartilage of the symphysis, which loosens. The symphysis cleft becomes wider in the course of this.
The purpose behind this is to make the pelvis more flexible for the child's birth and to adapt it to the new circumstances.

It is believed that they cause pain in the symphysis loosening by the pelvic bones are shifted unevenly against each other.

However, imaging diagnostics, such as x-rays, can not capture this. The x-ray, however, shows an enlarged symphysis cleft.

The symptoms usually occur in the middle of pregnancy and can vary greatly.
Women who suffered from the first pregnancy, have an increased risk in a second pregnancy again to suffer from this pelvic pain.

The localization of pain is not limited to the pubic area alone. Affected women also have pain in the groin, pelvis, back, hips and sacrum.

The pain can radiate up to the thighs and are located there, especially inside.

Furthermore, some women complain of a kind of rubbing or crunching in the pubic area, which can be very unpleasant.

The pain increases when spreading the legs or during physical exertion.
In addition, they are stronger at night than during the day and can thus rob you of sleep. Sleeping on the side is almost impossible.

What can one do against this painful matter?
First of all analgesics ( analgesics ) are given to relieve the pain quickly.

It is important, however, that the person concerned is gentle and in no way carries out heavy physical activities.
A support corset is used as part of an orthopedic treatment to stabilize the pelvis.

Pelvic floor exercises and light back exercises can relieve the symptoms. However, it is important to pay attention to freedom from pain.

Activities that cause pain should be avoided by the pregnant woman.

As a rule, complaints disappear after birth.
Only a few women hurts in the year after birth. Physiotherapeutic exercises can help here.

"Mother tape pain" in pregnancy

This term describes a rather nonspecific symptomatology. It is a stinging and pulling pain in the abdomen, which can occur from about 20 weeks gestation .

Basically, such a pain can have very different causes. One of them is a painful stretching of the uterine ligaments.

These include above all the ligamentum teres uteri ( also called ligamentum rotundum in gynecology ) and the ligamentum latum.
Of course, like the uterus, these ligaments become increasingly stretched as the child gets bigger.

Heat can provide relief here.
A restraint and the avoidance of a frequent change of position can further relieve the pain. Therapy is not necessary.

Low back pain in pregnancy

Low back pain often occurs in the third trimester.

Unfortunately, low back pain during pregnancy is not uncommon. They can be absolutely harmless and disappear from one day to the next, but they can also be the indication of a situation in need of therapy.

In the first trimester of pregnancy, low back pain may be due to rapid uterine growth or unfavorable posture.
However, such early low back pain can also be an expression of ectopic pregnancy.
They can also be an indication of a miscarriage.

Later in the pregnancy, low back pain is just too normal. An increased stretching of muscles and ligaments, as well as the shift of the body's center of gravity forward, can cause lower back pain.

In any case, a doctor can provide certainty and show the pregnant woman movements that can relieve the pain. Physiotherapy and light fitness training can also help.
In any case, the lifting of heavy loads should be avoided.

miscarriages

Abortions are slightly different depending on the week of pregnancy.
In early pregnancy clinically vaginal bleeding and labor-like pain in the lower abdomen and lower back pain.

In late pregnancy, the main feature is the loss of amniotic fluid and the onset of labor.

A miscarriage necessarily requires immediate medical supervision.
In early pregnancy, usually a curettage ( a scraping ) of prematurely deceased body fruit is performed.

In late pregnancy, however, a natural birth must take place.
Since an abortion is a highly stressful event for the psyche of the expectant mother, psychological counseling after this is recommended.

Premature birth (23rd -37th week of pregnancy)

Back pain, pain in the lower abdomen and pelvis, drip and labor-like pain indicate a premature birth from the 23rd week of pregnancy .

hip pain

In pregnancy, the pelvis is subjected to great stress, in some cases it comes to a symphyseal loosening, which can lead to severe hip pain.

The pubic symphysis ( symphysis pubica ) is a cartilaginous joint at the front of the pelvis. During pregnancy, the body produces the hormone relaxin, which makes the ligaments and in the pelvis softer and more flexible. The hip pain probably arises from the fact that now the loose straps one side of the pelvis when walking or moving the legs more leeway than the other. The pain usually occurs in the pubic area and in the groin area.

The hip pain in pregnancy often increases in certain movements such as Climb stairs or turn in bed . They can also be amplified at night.

In rare cases, it can lead to a diastasis of the symphysis, while the pubic symphysis is loosened so far that an unusually wide distance between the pelvic bones arises.

The hip pain caused by a symphyseal diastase can be alleviated by an orthopedic support belt for the pelvis. But other therapeutic options such as acupuncture, osteopathy or chiropractic can help. Regular pelvic floor exercises can reduce the burden on the pelvis during pregnancy.

During pregnancy, hip and buttocks pain can occur in the course of a piriformis syndrome. The growing child presses on certain structures in the pelvis, which has the consequence that a nerve is compressed. In most cases, the hip pain after childbirth decreases rapidly, rarely the symptoms persist for up to one year.

Headache in pregnancy

Headaches can occur more often during pregnancy. Especially in the first few months of pregnancy, some women complain of headaches. The causes of headaches can be varied, but are usually rather harmless. Since serious causes can rarely be the cause, one should consult a doctor for headaches that are present over a longer period or worsen significantly.

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Summary

Pain in pregnancy can have many causes.
Many of these causes are physiological and harmless. It is normal for the child to experience abdominal and abdominal pain as the baby grows and the uterus becomes stretched.

In addition, the additional weight also causes back pain. Therefore, pregnant women should pay attention to a sufficient protection of their body and avoid the lifting of heavy loads, for example.

The localization of pain varies from woman to woman and has different causes.

Pelvic pain may be a symptom of sympathetic loosening. Abdominal pain, for example, indicates a stretched uterine ligament.

However, caution should be exercised with concomitant symptoms such as vaginal bleeding, burning sensation, nausea and vomiting and a doctor should be consulted immediately.

Labor-like pain in early pregnancy accompanied by bleeding may indicate an abortion.
Pains of this kind in late pregnancy and the leakage of amniotic fluid may also be due to a threatened miscarriage.

Furthermore, premature births cause pain in the back, lower abdomen and pelvis and are accompanied by diarrhea.

In addition, pregnancy problems can cause pain.

Myoma of the uterus, depending on its location and size, is the cause of a painful pregnancy, as it, for example, adversely affects the position of the child and the uterus.

So you can see that there are many reasons for pain in pregnancy. Since the pain is very unspecific, only the medical diagnosis can provide certainty about the cause.

Aches and Pains During Pregnancy | Kaiser Permanente (December 2019).


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