Severe Lower Abdominal Pain in Late Pregnancy: Causes and Concerns

Pregnancy-related issues

I am currently two days away from nine months pregnant, and I have been experiencing severe pain in the lower right side of my abdomen for the past few days.
Resting for a while hasn't improved the situation, and sometimes I also feel intermittent pain in the lower left side, which has been ongoing for almost a day.
There hasn't been any bleeding.
Could you please tell me what might be the cause?

Pan Pan, 10~19 year old female. Ask Date: 2021/09/23

Dr. Wu Xianghui reply Obstetrics and Gynecology

If symptoms persist, it is recommended to visit a clinic or hospital for examination.

Reply Date: 2021/09/23

More Info

Severe lower abdominal pain during late pregnancy can be concerning, especially as you approach your due date. At 36 weeks pregnant, your body is undergoing significant changes as it prepares for labor, but persistent or severe pain should not be ignored. There are several potential causes for this type of pain, and understanding them can help you determine the best course of action.

1. Round Ligament Pain: As your uterus expands, the round ligaments that support it can stretch and cause sharp pain, typically felt on one side of the lower abdomen. This pain can be exacerbated by sudden movements, coughing, or changing positions. While this is common and usually not serious, it should not be severe or persistent.

2. Braxton Hicks Contractions: These are practice contractions that can occur in the third trimester. They are usually irregular and can cause discomfort, but they should not be painful or last for an extended period. If you are experiencing regular contractions that become increasingly painful, this could indicate the onset of labor.

3. Ovarian Cysts or Complications: Sometimes, ovarian cysts can cause pain during pregnancy. If a cyst ruptures, it can lead to sharp pain and discomfort. While this is less common, it is a possibility that should be evaluated by a healthcare provider.

4. Placental Abruption: This is a serious condition where the placenta detaches from the uterus before delivery. It can cause severe abdominal pain and may be accompanied by bleeding. If you experience any bleeding or severe pain, it is crucial to seek immediate medical attention.

5. Preterm Labor: If the pain is accompanied by regular contractions, lower back pain, or changes in vaginal discharge, it could indicate preterm labor. This is a medical emergency, and you should contact your healthcare provider immediately.

6. Gastrointestinal Issues: Sometimes, abdominal pain can be related to gastrointestinal problems, such as constipation or gas. While these are not directly related to pregnancy, they can cause significant discomfort.

Given that you have been experiencing severe pain for almost a day without improvement, it is essential to consult your healthcare provider. They can perform a thorough evaluation, which may include a physical examination, ultrasound, or other diagnostic tests to determine the cause of your pain.
In the meantime, here are some general recommendations:
- Rest: Try to rest as much as possible. Lying on your left side can improve blood flow to your baby and may help alleviate some discomfort.

- Hydration: Ensure you are well-hydrated, as dehydration can lead to contractions and discomfort.

- Monitor Symptoms: Keep track of any additional symptoms, such as bleeding, changes in fetal movement, or the frequency and intensity of contractions.

In conclusion, while some abdominal discomfort can be normal in late pregnancy, severe and persistent pain warrants immediate medical evaluation. Your healthcare provider is the best resource to assess your symptoms and ensure both your health and the health of your baby. Remember, it is always better to err on the side of caution when it comes to pregnancy-related concerns.

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