Pregnancy (More Than 20 Weeks) - Abdominal Pain

Pregnancy (More Than 20 Weeks) - Abdominal Pain

Is this your symptom?

  • Pain or discomfort in the abdomen (stomach area). This is the area below the rib cage and above the thighs.
  • More than 20 weeks pregnant

Causes

  • Abruptio placentae
  • Appendicitis
  • Fibroid
  • Gallbladder disease
  • Gastritis, peptic ulcer disease
  • Gastroenteritis (stomach flu)
  • Gastroesophageal Reflux Disease (GERD or heartburn)
  • Labor and preterm labor
  • Nonspecific abdominal pain
  • Preeclampsia
  • Round ligament pain
  • Uterine rupture

When Should You Seek Medical Help Right Away?

Here are some signs that the stomach pain during the second half of pregnancy might be serious. You should seek medical help or call your doctor right away if:

  • Moderate to severe stomach pain
  • Stomach pain is constant and lasts more than one hour
  • Vaginal bleeding or spotting
  • Fever with stomach pain
  • Your baby is moving less

Pain Scale

  • None: No pain. Pain score is 0 on a scale of 0 to 10.
  • Mild: The pain does not keep you from work, school, or other normal activities. Pain score is 1-3 on a scale of 0 to 10.
  • Moderate: The pain keeps you from working or going to school. It wakes you up from sleep. Pain score is 4-7 on a scale of 0 to 10.
  • Severe: The pain is very bad. It may be worse than any pain you have had before. It keeps you from doing any normal activities. Pain score is 8-10 on a scale of 0 to 10.

When to Call for Pregnancy (More Than 20 Weeks) - Abdominal Pain

Call 911 Now

  • Severe stomach pain lasting more than one hour
  • Severe vaginal bleeding (non-stop bleeding or large blood clots)
  • Passed out (fainted)
  • Very weak (can't stand)
  • You think you have a life-threatening emergency

Call Doctor Now or Go to ER

  • Stomach pains come and go (cramps), and last more than 24 hours
  • Fever over 100.4° F (38.0° C)
  • Whites of the eyes have turned yellow
  • New hand or face swelling
  • You think you are in labor (having contractions)
  • You think your bag of water broke (leaking fluid from vagina)
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Call Doctor Within 24 Hours

  • Yellow, green, or gray vaginal discharge
  • Pain or burning with passing urine
  • Blood in urine

Call Doctor During Office Hours

  • Stomach pains going into chest, with sour taste in mouth
  • Stomach pains often occur 1 hour after meals
  • Stomach pains off and on for weeks or months (are frequent, come and go)

Self Care at Home

  • Mild stomach pain
  • Questions about round ligament pain (already diagnosed by your doctor)
  • Questions about heartburn (already diagnosed by your doctor)

Care Advice

Mild Stomach Pain

  1. What You Should Know:
    • Mild stomach pain can be caused by an upset stomach, gas pains, or eating too much. Sometimes mild stomach pain is the first sign of a vomiting illness like stomach flu.
    • In pregnant women, mild stomach pain can also be caused by heartburn or round ligament pain.
    • You can treat mild stomach pain at home.
    • Here is some care advice that should help.
  2. Rest: Lie down and rest until you feel better.
  3. Fluids: Sip only clear fluids until the pain is gone for over 2 hours. Clear fluids include water, broth, and water mixed with fruit juice. Then slowly return to a normal diet.
  4. Diet:
    • Start with clear liquids. When you feel better, you can begin eating a bland diet.
    • Avoid alcohol or drinks that have caffeine in them.
    • Avoid greasy or fatty foods.
  5. Pass a Bowel Movement (BM): Sit on the toilet and try to pass a BM. Do not strain. Having a BM can help pain caused by diarrhea or constipation.
  6. Expected Course:
    • With harmless causes, the pain is usually better or goes away in 2 hours.
    • With gastroenteritis ("stomach flu"), belly cramps may occur before each bout of vomiting or diarrhea.
    • With round ligament pain, pain is usually brought on by sudden movement or change in position.
    • With constipation or gas, the pain is usually relieved by having a bowel movement.
    • With serious causes (such as appendicitis), the pain becomes constant and severe.
  7. Your Next Doctor Appointment:
    • Be certain to go to see your doctor at your next scheduled appointment.
    • Tell the doctor about this pain and any other symptoms you are having.
  8. Call Your Doctor If:
    • Severe stomach pain occurs
    • Stomach pain is constant and lasts more than 2 hours
    • Stomach pains come and go, and last more than 24 hours
    • Vaginal bleeding or spotting
    • Your baby is moving less
    • You think you need to be seen
    • You get worse

Baby Movement and Kick Count Instructions

  1. Baby Movement and Pregnancy Dates:
    • 1-15 Weeks: Baby is too small for mother to feel the baby move.
    • 16-18 Weeks: Some women begin to feel the baby move, especially if they had a baby before.
    • 18-20 Weeks: Most women begin to feel the baby move around this time.
    • 24 Weeks: All women should feel the baby move by this time.
    • Over 28 Weeks: Some doctors advise that women check kick counts each day.
  2. How to Do a Kick Count:
    • Pick the time of the day that your baby is most active.
    • Sit back in a comfortable chair or lie down on your left side in bed.
    • Do this in a quiet room (no TV, cell phone, computer, or children).
    • Count any baby movement (kicks, rolls, flutters). Count up to 10.
    • Normal Kick Count: 5 or more in one hour, or 10 or more in 2 hours.
    • Low Kick Count: Less than 5 in one hour, or less than 10 in 2 hours.
  3. Call Your Doctor If:
    • Low kick count (less than 5 in 1 hour, or less than 10 in 2 hours)
    • Kick count is normal, but you still are worried that something is wrong
    • You have other questions
    • You think you need to be seen
    • You become worse

Round Ligament Pain - Questions About

  1. What You Should Know:

    • The round ligament helps hold up your womb (uterus) in your pelvis.
    • As your baby and womb grow during pregnancy, there is more weight pulling on the round ligament. This stretches the round ligament and causes pain.
    • What are the symptoms? The main symptom is mild pain in the lower stomach area on one or both sides. The pain can be sharp or dull. It is usually worse when standing up or walking. It gets better with lying down. It usually starts between 18 and 24 weeks of pregnancy.
    • What makes it worse? Sudden movements can bring on this pain. For example, you may roll over in the middle of the night and have a sudden sharp pain. Sitting up quickly or changing positions can also trigger round ligament pain.
  2. Treatment:
    • Stay active. Walking, yoga, and gentle stretching can all be healthy. Talk with your doctor abour exercise.
    • Avoid sudden changes in position. Get up from bed or from a sitting position slowly.
    • Try heat. Apply a warm wet towel to area or take a warm bath.
  3. Over-The-Counter Medicine:
    • You can take over-the-counter acetaminophen (Tylenol) for pain, if needed.
    • Remember, talk with your doctor about any medicines you take.
    • Read the instructions and warnings on the package insert for all medicines you take.
  4. Call Your Doctor If:
    • Severe stomach pain occurs
    • Stomach pain is constant and lasts more than 2 hours
    • Stomach pains come and go, and last more than 24 hours
    • Vaginal bleeding or spotting
    • Your baby is moving less
    • You think you need to be seen
    • You get worse

Heartburn - Questions About

  1. What You Should Know:
    • Heartburn is common during pregnancy, especially during the second and third trimesters. It occurs when stomach acid backs up into the foodpipe (esophagus).
    • The medical term for heartburn is Gastro-Esophageal Reflux Disease (GERD).
    • What are the symptoms? The main symptom is a burning pain in the center of the lower chest. It can also cause a sour taste in the mouth or throat.
    • What makes it worse? Fatty or greasy foods, spicy foods, drink that contain caffeine, mints, and chocolate can cause heartburn or make it worse. Eating too large a meal or lying down right after eating can cause heartburn.
  2. Prevention - Some General Tips:
    • Do not eat during the 2 hours before bedtime.
    • Eat smaller meals. Eat 4-6 smaller meals each day instead of larger meals.
    • Avoid any foods that make it worse. For example: fatty or greasy foods, spicy foods, drinks with caffeine, mints, and chocolate.
    • Sleep with your head elevated. Gently prop your head and upper back up with a couple pillows at bedtime. Some women put wooden blocks or bricks (2-4 inches or 5-10 cm high) under the legs of the head of the bed.
  3. Medicines:
    • Talk to your doctor if the heartburn does not get better.
    • There are over-the-counter and prescription medicines that can help.
    • Read the instructions and warnings on the package insert for all medicines you take.
  4. Call Your Doctor If:
    • Severe stomach pain occurs
    • Stomach pain is constant and lasts more than 2 hours
    • Stomach pains come and go, and last more than 24 hours
    • Vaginal bleeding or spotting
    • Your baby is moving less
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: This information is not intended to be a substitute for professional medical advice. It is provided for educational purposes only. You assume full responsibility for how you choose to use this information.


Last Reviewed: 7/20/2017 1:10:43 AM
Last Updated: 5/7/2017 1:36:15 PM

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