There are many possible causes of stomach pain during pregnancy. Some of these may be obstetric in that it is related to the pregnant states, while other causes may be non-obstetric affecting any woman irrespective of pregnancy. This is discussed further under the Causes of Abdominal Pain in Pregnancy.
When to Seek Medical Help for Abdominal Pain in Pregnancy
- If mild abdominal pain lasts for more than a week.
- If pain is severe or increases in intensity.
- Severe and persistent pain which is not relieved even after resting for several minutes.
- Pain that gets worse with any physical activity.
- If pain worsens or does not ease despite taking pain relieving medicines.
- If it is accompanied by other symptoms such as fever, diarrhea, vomiting, vaginal bleeding, dizziness, fainting.
- In case of a sudden sharp pain in the abdomen.
- There is associated pain elsewhere, such as tip of the shoulder.
- The abdomen is hard and painful to touch.
- In addition to abdominal pain, fetal movement seems sluggish or less.
Treatment of Abdominal Pain in Pregnancy
Treatment of abdominal pain in pregnancy will depend upon the cause. Mild pain, if not due to any significant cause, may improve with rest and on modifying daily activities. General measures such as oxygen, intravenous fluids and medications, should be implemented where indicated. For other obstetric and non-obstetric causes of abdominal pain in pregnancy, the following measures may be undertaken.
- In case of unruptured ectopic pregnancy, medical treatment with methotrexate may be undertaken, or surgical treatment such as salpingotomy or salpingectomy may be done.
- Immediate laparoscopy or laparotomy is the treatment of choice in case of ruptured ectopic pregnancy.
- Management of spontaneous abortion will depend upon the type of abortion.
- Threatened abortion may be treated with rest and pain relieving drugs.
- Treatment of inevitable and incomplete abortions may require the drug misoprostol or by D&C.
- Intravenous antibiotics will be needed in case of septic abortion.
- Delivery of the fetus may be indicated in certain conditions. The mode of delivery will depend upon the indication.
Surgery in Pregnancy
In case of acute surgical problems such as acute appendicitis, immediate surgery is definitely indicated. In other cases where surgery is advisable for a condition but there is no indication for an immediate operation, it is always preferable to postpone the surgery until after a suitable period following delivery.
If surgery becomes necessary during pregnancy, performing it in the second trimester is a better option. An operation done in the first trimester carries the risk of miscarriage, as well as dangers of drugs used for anesthesia. Surgery done in the third trimester may result in preterm labor. Laparoscopic surgery is considered safe in any trimester when performed by an experienced and competent surgeon.