Introduction

We have previously discussed the causes of stomachache during pregnancy in an extensive post. In this quick review, we aim to briefly recount some of the more serious causes of abdominal pain during pregnancy and some accompanying symptoms which may be experienced in association with them.

As previously mentioned, it is not rare to experience stomach upsets throughout pregnancy. However, when paired with other signs and symptoms, this might be an indication of a more serious underlying etiology. Here are some associated symptoms that would prompt further investigations. When faced with such red flags, it is important to seek immediate professional help.

• Nausea and Vomiting

Experiencing nausea and vomiting could be a normal physiological experience, especially during the first few weeks. However, this would rarely lead to the inability to eat or drink. It is important to replace the lost water through vomiting with vigorous fluid and electrolyte intake to prevent dehydration. If the sensation of nausea and vomiting is so strong that it prevents you from taking your food, water, or supplements, it means that a more serious etiology may be at play. You may require intravenous fluid replacement therapy with serum in such cases.

Experience of any additional symptom with nausea and vomiting, such as fever, diarrhea, dehydration, or bleeding requires a proper medical workup to ensure the wellbeing of your pregnancy.

• Dehydration

It is important to watch out for signs of dehydration, especially when experiencing vomiting in pregnancy. This is due to increased loss of fluids with vomiting, and the fluid retention in the extracellular space. When vomiting is paired with dehydration and your inability to make up for the lost water via oral intake, it is important to seek medical attention and prevent prolonged periods of dehydration.

The earliest signs of dehydration include feeling thirsty, dry skin and dry mouth. In more severe or prolonged cases, a thick or dark urine, decreased amount of urine, and lack of urination may be experienced, which indicates severe dehydration.

• A Change in the Pattern of Pain

You may have already experienced some mild and harmless abdominal pain in your early days of pregnancy. However, a sudden change in the pattern or severity, including the timing of pain, association with eating or hunger, a pain that moves around in your stomach or localizes to a specific region, or addition of accompanying signs, such as fever, headaches, or weakness, requires further workup.

It is important to monitor such changes and seek immediate help if experiencing them to ensure everything is in order or if any treatments are indicated.

• Bleeding

Generally speaking, any bleeding throughout pregnancy needs further workup to rule out serious causes. Even though some minimal vaginal bleeding may be experienced as “Implantation bleeding” within the early weeks of pregnancy, more serious causes such as loss of pregnancy could be the underlying cause and it is important to rule them out with proper investigations, such as serum pregnancy test and ultrasound studies.

Additionally, if you experience bleeding with vomiting, or rectal bleeding (such as blood mixed with diarrhea, constipation, or experience of a thick, slimy, tarry black stool), or with urination, a proper workup would be indicated.

• Fever

Fever is mostly never considered a normal finding, especially with pregnancy. It often indicates an ongoing infectious process, and accompanying signs may lead to the source of this infection. Whether a simple upper respiratory infection, such as a common cold, or with more serious intra-uterine infections which directly affect the wellbeing of the fetus, it needs proper assessment and management.

Fever may be associated with cough and nasal discharge, indicating a respiratory infection, or with diarrhea or nausea and vomiting, indicating gastrointestinal infection, or with vaginal discharge, itching, bleeding, or pain, indicating a genital source of infection. Furthermore, urinary infections are also common with a burning sensation with urination or a foul-smelling urine.

• Pain after injury

It goes without saying that you need immediate medical attention if you have been injured while pregnant. Any penetrating injury, any injury to the stomach area, experiencing sustained pain after injury, or any vaginal bleeding after the incident point towards ominous outcomes. Regardless of the severity, it is important to have your and your fetus’ well-being checked.

Conclusion

In conclusion, we have reviewed some of the symptoms that require proper medical investigation and a healthcare professional’s advice in pregnancy, when experienced in addition to abdominal pain. While some mild abdominal pain, nausea and vomiting, and vaginal bleeding may be expected in normal pregnancies, experiencing severe nausea and vomiting, inability to take in food or water, dehydration, diarrhea, fever, a change in the pattern or location of pain, any associated bleeding, or accompanying injuries need a timely investigation, including ultrasound studies and bloodwork.

Please let us know in the comments what you think about this topic, and if you think we have missed any important aspects. We would love to hear about your experiences and challenges when dealing with abdominal pain in pregnancy.