I am three months pregnant and as a new mum, of course it is exciting. However, this last month, I have been feeling pain in my abdomen that is rather unusual. I literally can’t sleep on my stomach and I think it is still too early for that. I feel pain when I do. I went to a small neighbourhood health centre and the doctor told me it was normal to feel that way. But the pain won’t go away and I’m beginning to worry. Should I be worried or is this normal? One friend of mine actually told me she had the same pain but it eventually stopped.

Clarisse

Dear Clarisse

Pain in the abdomen can be due to multiple reasons. Dyspepsia, gastritis, constipation, peptic ulcer, urinary tract infection, intestinal infections, can all cause pain in a normal person as well as a pregnant woman.  The diagnosis depends on the site of pain, its character, frequency and intensity along with relevant investigations done.

A pregnant woman becomes more susceptible to urinary tract and pelvic infections. The susceptibility is enhanced more if she develops gestational diabetes (diabetes of pregnancy). However this would be accompanied by other symptoms like frequency and urgency of urination, burning pain while passing urine and pain in the lower abdomen and back. 

If one has suspicion of urinary tract infection, an early morning sample of urine can be examined microscopically. Presence of microbes confirms the diagnosis. Taking a complete course of a suitable antibiotic will cure the condition completely.However, pain can also occur in early pregnancy exclusively due to pregnancy. As the baby grows, there is stretching of the pelvic ligaments and muscles. Stretching of the round ligament which supports the uterus causes pain.  This may be mild and perceived as discomfort or maybe even a severe cramp like pain, which may be frightening. 

However this pain goes off spontaneously and there is nothing to worry about.  At times, intercourse during pregnancy can also cause pain due to the impact of thrust on the pregnant uterus.   But if the pain is severe, persistent or accompanied by even mild bleeding, one should seek immediate medical attention. Because then there is risk of ectopic pregnancy or miscarriage, both of which are obstetric emergencies.

If the physiological pain occurring during pregnancy is tolerable, there is nothing to do about it. However if the pain is severe, using a hot water bag would be useful. However the water used should be comfortably lukewarm only. Change in position when the pain occurs also helps to reduce the pain as you have already experienced.  

Drinking a lot of water helps to prevent urinary tract infections as the infectious germs are expelled along with urine. One should also be careful about hygiene during intercourse. It is good to pass urine and wash the genitals immediately after intercourse. This helps to prevent deposition of infectious germs over the genitals and subsequent pelvic infection.

Eating fresh fruits and green vegetables helps to prevent constipation, which can cause discomfort and pain in the abdomen.

If pain recurs after the above measures or is persistent, it is advisable to get urine and stool tested to search for a treatable cause for the pain.

Dr. Rachna is a specialist in internal medicine at Ruhengeri Hopsital