Pregnancy, Round Ligament Pain

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Pregnancy, Round Ligament Pain Overview

 

Abdominal pain during pregnancy is common.  Most often it is a result of round ligament pain. Round ligament pain is due to normal changes that take place as your body is transformed by pregnancy. There are other, abnormal, treatable causes of pain that your health care provider may want to check. Therefore, any new or significant pain should be reported to your doctor.

Pregnancy, Round Ligament Pain Causes

Round ligament pain refers to a type of pelvic pain caused by stretching of the round ligaments. This occurs more commonly on the right side of the pelvis.

  • Your uterus is normally the size of a pear. Thick ligaments, one of which is called the round ligament, hold your uterus in suspension within your abdomen. As the uterus grows in size and weight , these ligaments become very long and thin, stressing and tensing like rubber bands.
  • The ligaments pull and tug on nearby nerve fibers and sensitive structures, causing pain. The severity of pain can worry you. Although round ligament pain is uncomfortable, it is also very normal.
  • A ligament spasm, an involuntary contraction or cramp, usually triggers a sharp pain. These spasms are found more frequently on the right side than the left because of the normal tendency of the uterus to turn to the right.
  • You might awaken at night with pain after having suddenly rolled over in your sleep .
  • The pain may also be brought on by exercise .

Pregnancy, Round Ligament Pain Symptoms

Pain from stretching uterine ligaments can be severe and can be confused with causes outside your pregnancy. Pregnant women often feel acute abdominal pain when the cause is something more serious, such as the following:

  • Appendicitis - An inflammation of the appendix located in your right lower abdomen. You initially have poor appetite, nausea , vomiting, fever, and, as the inflammation progresses, worsening pain. As you move further along in your pregnancy, the pain from appendicitis will be felt in the upper abdomen instead on the lower abdomen because of your growing uterus.
  • Pain in ovaries or cysts. The ovary located in this area may twist, or a cyst may rupture, causing sudden severe abdominal pain. The pain may also indicate a ruptured ovarian cyst .
  • Abnormal growths in the abdominal area
  • Cramps because of slow digestion caused by pregnancy (These occur in the ascending colon and cecum, located in the right lower part of your abdomen.)

When to Seek Medical Care

 

Describe your pain, and any other symptoms, to your health care provider, who will assess whether to send you to a hospital’s emergency department. Do not hesitate to seek emergency care if any of the following symptoms occur.

  • Fever
  • Chills
  • Pain on urination
  • Difficulty walking

Exams and Tests

If you need to go to the emergency department, the emergency doctor will examine you to make sure no acute life-threatening condition exists. The basic examination if you have lower abdominal pain typically includes an abdominal, pelvic, and digital rectal examination. Although the exam may be uncomfortable, important diagnostic findings on the physical examination will direct the doctor into ordering appropriate laboratory tests. Ultimately, this will enhance the doctor’s knowledge of your condition and further direct your treatment plan.

  • The doctor may also order some basic laboratory tests, which will help to assess the overall health of you and your baby .

    • A complete blood count (CBC) is a blood test that detects anemia or a possible infection. Often, pregnant women will be slightly anemic. Your white blood cell count may be slightly higher, which is normal in pregnancy.
    • A urine sample may be tested.

      • Pregnant women with lower abdominal pain may have a urinary tract infection. This could place you and your unborn baby at risk for severe prenatal complications.
      • Often, severe flank pain may represent the passage of a kidney stone . The finding of blood in your urine may assist in making this diagnosis.
  • The doctor may perform an ultrasound of the pelvis if you are not sure of the exact date you became pregnant or if the pain represents a more life-threatening condition

    • Ectopic pregnancy remains the most life threatening of disorders in early pregnancy.
    • Ovarian cysts are common in early pregnancy and tend to rupture. When a ruptured cyst produces blood in your pelvis, it may be difficult to distinguish from a ruptured ectopic pregnancy .
    • An ultrasound may detect appendicitis.

Pregnancy, Round Ligament Pain Treatment

 

After your condition has been evaluated, your health care provider will develop a treatment plan. If all acute emergencies have been completely ruled out, you may be sent home safely with strict instructions to follow.

  • You may be advised to return to the emergency department or doctor’s office if your pain worsens or persists despite basic therapy with acetaminophen (Tylenol ).
  • You may also be asked to modify your daily activity level and avoid positions that may worsen the condition.

 

Self-Care at Home

 

  • Applying heat to the area may relieve pain:
    • Hot soaks
    • A heating pad
    • A hot bath
  • Lying on the opposite side may also relieve the pain.
  • Often, the pain may ease as your pregnancy progresses.
  • Changing how you move-rising or sitting down more gradually, avoiding sudden movement-may decrease the spasms.
  • Talk with your health care provider first, but you may be advised about the use of acetaminophen (Tylenol) to reduce pain.

Next Steps

 

Follow-up

After you have been reassured that your general health is fine, you should avoid specific factors that trigger this pain.

  • Lying on the opposite side and applying warm soaks early may alleviate the pain.
  • Your health care provider should advise you about using acetaminophen (Tylenol).

Prevention

Not every woman who is pregnant will experience round ligament pain.

  • One thing is certain: When you are pregnant, you experience changes in your body.  In particular, the ligaments that were one thick band are now very long and thinly stretched as they support your uterus.
  • This change is caused by the release of progesterone and the growing fetus in your uterus.
  • These changes, while natural, are unavoidable. As a result, there are no proven preventive exercises or remedies for this pain.

Outlook

 

If you have been seen by your doctor and know that your pregnancy is not ectopic, not associated with bleeding, and not associated with uterine contractions , you are probably experiencing one of the more common discomforts of pregnancy.

  • For most women, the pain will go away simply by changing daily activities.
  • Except for rare cases, the pain may last throughout the entire second and third trimesters of your pregnancy.
  • Once your child is delivered, the pain should completely go away.

Sun, 24 Oct 2010 @05:59

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