General Practice 2022

Cólica in pregnancy: main causes and how to alleviate

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Cólica in pregnancy: main causes and how to alleviate
Cólica in pregnancy: main causes and how to alleviate

Colic in pregnancy is normal, especially at the beginning of pregnancy, due to the implantation of the embryo and adaptation of the woman's body to the baby's growth, and also at the end of pregnancy, around 37 weeks of gestation, giving signs of the beginning of labor.

However, there are other conditions that can cause severe cramping, such as ectopic pregnancy, placental or ovule detachment, or miscarriage, and which may be accompanied by other symptoms such as vaginal bleeding, discharge, or fever.

It is important to contact the obstetrician or look for the nearest hospital when symptoms of frequent, painful colic that do not stop even at rest appear, so that an evaluation by the doctor is carried out and the most appropriate treatment is initiated, which depends on the cause of colic.

1st trimester colic

The main causes of colic in the 1st trimester of pregnancy, which corresponds to weeks 1 to 13 of pregnancy, are:

1. Embryo implantation

Colic in early pregnancy is normal and can be caused by the implantation of the embryo in the uterus, which occurs about 6 to 12 days after fertilization, and there may also be a small pinkish bleeding, and usually lasts for about 2 days.

In this early stage of pregnancy, the fertilized egg implants in the uterus, starting the division of the embryo's cells and stimulating the woman's body to produce the beta-HCG hormone to create conditions for the baby to develop inside the uterus, and there may also be symptoms such as morning sickness or breast tenderness, which can be confused with PMS symptoms. Learn how to differentiate symptoms of PMS and pregnancy.

How to relieve: When experiencing cramping in early pregnancy, it is recommended to rest and relax, which can help relieve the discomfort of colic related to implantation of the embryo, and that usually gets better within 2 days.

2. Tubal pregnancy

Tubic pregnancy, also called ectopic pregnancy, occurs when the embryo develops outside the uterus, being more common in the fallopian tubes, also called fallopian tubes, and can cause intense cramping on only one side of the belly and that gets worse with movement.

Colic caused by tubal pregnancy is usually accompanied by other symptoms such as vaginal bleeding, pain during intimate contact, dizziness, nausea, vomiting or fainting.

How to relieve: in the event of symptoms of tubal pregnancy, the nearest emergency department should be sought immediately so that tests are carried out, confirm the diagnosis and start treatment most suitable, which is usually done from a surgery to remove the embryo. Find out how ectopic pregnancy is treated.

3. Urinary tract infection

Urinary infection is very common during pregnancy, and may not cause symptoms at an early stage, but can often cause colic in the pelvic region, burning and difficulty urinating, urgent urge to urinate even though there is little urine, fever and nausea.

Urinary infection is more frequent in early pregnancy, but it can also appear at any stage of pregnancy, due to the changes that occur in the woman's body during pregnancy, which can favor the development of bacteria in the urinary tract.

How to relieve: you should consult your obstetrician for a urine test to confirm the urinary tract infection and start treatment with antibiotics, such as cephalexin, for example. In addition, it is recommended to rest, increase fluid intake and not hold urine. See more about treating urinary tract infection in pregnancy.

4. Ovular detachment

Ovular detachment is a condition that occurs due to an accumulation of blood between the placenta and the uterus caused by the detachment of the gestational sac from the wall of the uterus, and which can lead to colic, bleeding or abdominal pain.

Ovular detachment, scientifically called subchorionic or retrochorionic hematoma, is a situation that can happen during the first trimester of pregnancy and, in milder cases, it can disappear by itself until the end of the second trimester of pregnancy, because is absorbed by the woman's body.

However, when the hematoma is large, there is an increased risk of premature birth, miscarriage, or placental abruption.

How to relieve: it is important to look for the nearest hospital immediately so that the ultrasound is performed and the need to start the most appropriate treatment evaluated, which can be done with partial rest or absolute, avoid intimate contact, and in some cases, hormonal treatment with progesterone, indicated by the doctor. In addition, it is also important to drink at least 2 liters of water a day. See more details on the treatment of ovular detachment.

5. Miscarriage

Spontaneous abortion can cause severe cramping in the lower part of the belly, pain in the lower back and/or pelvis, accompanied by brownish bleeding, heavy bleeding or blood or tissue clots, which worsen over the days. In addition, colic may be accompanied by other symptoms such as intense or constant headache or general malaise.

Spontaneous abortion is more common in the first trimester of pregnancy, but it can also occur in the second trimester of pregnancy, before 20 weeks, due to various situations, such as excessive physical activity, use of medication, consumption from certain teas, infections or trauma. Learn about other causes of miscarriage.

How to relieve: the emergency room should be sought immediately in case of spontaneous abortion symptoms, to perform tests such as ultrasound and assessment of the fetal heartbeat, and thus have the diagnosis. In the case of confirmation of miscarriage, the treatment must be carried out by the doctor through a curettage or surgery to remove the baby. Learn how curettage is performed.

2nd trimester colic

The main causes of colic in the 2nd trimester of pregnancy, which corresponds to weeks 14 to 27 of pregnancy, are:

1. Pelvic pain

Pelvic pain, also called round ligament pain, can lead to cramping on one or both sides of the lower abdomen that lasts a few seconds or minutes and usually comes when a woman changes very quickly, when sitting or lying down, or when coughing or sneezing.

This condition is caused by the stretching and narrowing of the ligaments that support the belly, due to the growth of the uterus, being a normal condition of pregnancy.

How to relieve: Maintaining good posture, avoiding prolonged standing or sitting, and changing your position when lying down can help relieve discomfort. In addition, doing light stretches and gentle movements, practicing yoga or pilates, as long as they are approved by the doctor, help to strengthen the muscles to support the changes in the body during pregnancy. However, if the pain does not improve, or if you have a fever, you should contact your doctor immediately.

2. Placental detachment

Placenta detachment happens when the placenta is separated from the wall of the uterus as a result of inflammation or changes in blood circulation in the placenta, causing severe cramping, lower back pain and vaginal bleeding, being more common after 20 weeks of delivery. pregnancy.

Detachment of the placenta can be caused by intense physical exertion and high blood pressure or preeclampsia.

How to relieve: placental abruption is a serious situation that requires immediate intervention, as it can endanger the he alth of both mother and baby. Therefore, you should seek the emergency room as soon as possible so that treatment can be started, being necessary in some cases hospitalization, use of oxygen and control of blood pressure and heart rate. Learn more about treating placental abruption.

3. Training Contractions

Training contractions, also called Braxton-Hicks contractions, can appear around the 20th week of pregnancy, causing cramping that is mild and considered normal as the uterus muscles can contract and relax regularly, making the belly harder at certain times of the day, preparing the uterus and pelvic tissues for the future delivery.

How to relieve: Moving your body or doing physical exercises recommended by your doctor help relieve the discomfort of contractions. However, if the contraction is strong, very frequent, or accompanied by other symptoms such as back pain, vaginal bleeding, or fluid discharge, seek medical help immediately.

Colic in the 3rd trimester of pregnancy

The main causes of colic in the 3rd trimester of pregnancy, which corresponds to weeks 28 to 41 of pregnancy, are:

1. Constipation

Constipation is more common in the third trimester of pregnancy, and occurs due to pressure from the uterus on the intestines and decreased bowel movements, causing colic, pain on the left side, excess intestinal gas, in addition to the belly may be more hardened in that place of pain.

How to relieve: Keep your body hydrated by drinking at least 8 glasses of water a day and eating more fiber in the form of whole grains, fresh fruits and vegetables.Practicing physical exercises regularly recommended by the doctor, can also help improve intestinal transit and relieve this discomfort. However, it is recommended to consult the obstetrician if the pain does not improve on the same day, if you do not have a bowel movement 2 days in a row, or if other symptoms such as fever or increased pain appear.

2. Preeclampsia

Preeclampsia is a sudden increase in blood pressure in pregnancy, which is usually in the second half of pregnancy, being more common in the third trimester, causing symptoms such as cramping in the upper right part of the abdomen, nausea, pain headache, swelling of the hands, legs and face, in addition to blurred vision.

Preeclampsia is a serious complication of pregnancy that is difficult to treat and can pose a risk to both the woman and the baby.

How to relieve: It is recommended to consult the obstetrician as soon as possible to assess blood pressure and start treatment with hospital admission, to ensure the safety of mother and baby. Find out how preeclampsia is treated.

3. Premature labor

Cramping that appears after 37 weeks of gestation, which has progressive intensity and becomes more constant over time, and does not improve when the position is changed, may be indicative of preterm labor.

In addition, other symptoms may be accompanied by cramps, such as a feeling of pressure in the pelvic region, vaginal discharge or light bleeding. Learn how to identify contractions in pregnancy.

How to relieve: you should inform your obstetrician immediately when contractions start and go to the maternity or hospital.

When to go to the doctor

It is important for a woman to consult her obstetrician or go to the nearest emergency room immediately when colic is persistent or is accompanied by symptoms such as:

  • Vaginal bleeding;
  • Fever;
  • Chills;
  • Nausea or vomiting;
  • Pain or burning when urinating;
  • Blood urine;
  • Headache;
  • Swelling in hands, feet or face.

The presence of these symptoms may indicate a serious complication, which requires immediate care and treatment, which varies according to the doctor's diagnosis.

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