Stomach cramps in early pregnancy

If and when women experience any kind of stomach pain in the early stages of pregnancy, they tend to get very alarmed. They can’t exactly be called paranoid and unreasonable, as many cases of intense stomach cramps that women go through at the beginning of pregnancy are, in fact, a cause for concern. However, not all cases of stomach cramps early on in the pregnancy have that outcome.

What exactly are those harmless stomach cramps that occur in early pregnancy?

As everyone probably knows, the body of every woman is different, and women go through different periods in very different ways. And, pregnancy is no different than the rest of them. What that means exactly is that every woman experiences the raging hormones and their sudden shifts during pregnancy differently.

Some women simply have a more difficult time with them because they can manifest themselves through cramps and stomach pain. It’s just the same as morning sickness. Some women go through their entire pregnancy without having vomited once, and others have their morning sickness both in the morning and evening.

Why Do Stomach Cramps In Early Pregnancy Occur?

While sometimes these hormones are the reason for hormone changes, some other times they can occur due to the expansion of the uterus to make room for the growing baby. Some women do not even notice this process, but others can suffer its consequences in the form of cramping. This cramping is sometimes followed by some vaginal bleeding which can add to it being a scary experience, but it is as well one of the symptoms that some women experience.

How can one distinguish the alarming kind of cramps from the normal ones?

The difference in the manifestation of cramping that leads to a miscarriage, and the cramping that occurs due to the changes in the body of the pregnant woman is noticeable. First of all, while quite uncomfortable, normal cramps are not too intense, in fact, they are less intense than menstrual cramps.

The dangerous kind of cramps tends to be quite severe and unbearable, and they make the stomach extremely sensitive to touch. They are followed by profuse vaginal bleeding. Also, the pain is located more on the side of the stomach, rather than the center. This is because the miscarriage most frequently occurs due to an ectopic pregnancy, which basically means that the egg wound up in the fallopian tube instead of the womb.

Finally, while the normal cramping goes away on its own after a little while, the cramping that resulted from a miscarriage will most likely persist for quite a while.

Abdominal pain during pregnancy can be caused by a wide variety of diseases including disorders of the obstetric, gynecologic, gastrointestinal, hepatobiliary, genitourinary, and vascular systems. Some causes are unique to pregnancy, are exacerbated by pregnancy, or require an altered imaging algorithm for diagnosis during pregnancy.

The clinical diagnosis of an intraabdominal disease in pregnant women is often obscured by concurrent maternal physiologic and anatomic changes. Guarding in the setting of peritonitis may not occur because of the loss of elasticity in the abdominal wall musculature. Leukocytosis in pregnancy is less useful in clinical evaluation because WBC count is typically elevated in pregnancy, ranging from 6,000–16,000 cells/?L during the first and second trimesters to 20–30,000 cells/?L at the end of the third trimester. Ureteral compression and displacement of intraabdominal organs, including the appendix, by the gravid uterus may also confound the clinical presentation.
A delay in the diagnosis of many of the causes of abdominal pain can be threatening to both the mother and the fetus. Imaging can clarify a confusing clinical picture and expedite diagnosis. Ultrasound is widely used as the initial diagnostic imaging technique during pregnancy because of its availability, portability, and lack of ionizing radiation. Ultrasound often can elucidate the cause of abdominal pain, particularly if pain is due to an obstetric and gynecologic abnormality.
MRI is also a useful technique for imaging pregnant patients given the lack of ionizing radiation. Several recent studies have shown that MRI is valuable in evaluating abdominal pain during pregnancy, especially in the diagnosis of appendicitis, which is the most common cause of an acute abdomen in pregnancy. To date, no deleterious effects to the developing fetus exposed to MRI have been reported.
Examinations using ionizing radiation—in particular, CT—can also accurately diagnose many causes of abdominal pain during pregnancy. A risk–benefit analysis is particularly warranted before performing an examination involving ionizing radiation on a pregnant or potentially pregnant patient. However, most diagnostic imaging studies utilizing ionizing radiation do not expose the fetus to a radiation dose high enough to result in developmental or neurologic deficits.
Gastrointestinal causes of pain during pregnancy include appendicitis and other inflammatory, infectious, and obstructive processes of the bowel. These diseases are neither unique to nor more common in pregnancy but can be more difficult to diagnose during pregnancy. The approach to imaging the bowel of a pregnant patient also differs from that of a nonpregnant patient because ultrasound and MRI are typically preferred over techniques that impart ionizing radiation such as radiography and CT.
Two hepatic complications unique to pregnancy that can present with acute abdominal pain are HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome and acute fatty liver of pregnancy (AFLP). Although pancreatitis is not unique to pregnancy, the approach to imaging pregnant patients with pancreatitis differs from that of the nonpregnant patient.
Urinary tract causes of pain during pregnancy include physiologic and obstructive hydronephrosis and infectious causes such as cystitis and pyelonephritis, which do not usually require imaging for diagnosis and treatment. The incidence of urolithiasis is not increased during pregnancy. However, the approach to imaging urolithiasis and the need to differentiate between physiologic and obstructive hydronephrosis differs between pregnant and nonpregnant patients.
Vascular causes of abdominal pain that have a higher incidence in pregnancy include venous thromboembolic disease, gonadal vein dilatation, and splenic artery aneurysm rupture.