Pain in the abdomen is routine during pregnancy, it is often because of the stretching of round ligaments. Round ligament pain refers to cramps caused by stretching of the ligaments that proceed from the front of the uterus. This type of jabbing pain typically is experienced on the right side of the pelvis (this is because the uterus undergoes twist and turns as the pregnancy progresses).
The discomfort is often also felt on both sides of the lower abdomen or groin area triggered by movement, during the second trimester specifically. It is a common phenomenon that occurs in pregnancy, that affects 10-30% of pregnant women.
Round ligaments are thick bands of fibromuscular tissue that help support the uterus by connecting the front of the womb to the groin region in the pelvis. These ligaments stretch as the pregnancy progresses and the pain is associated with the tightening of the ligaments and irritation of nearby nerve fibres. It is triggered by spontaneous movement like turning over in bed or vigorous activity.
Causes of Round Ligament Pain:
• The ligaments support the uterus, they stretch and tense as a result of it growing in size and weight. This strains the ligaments.
• The ligaments pull on nearby nerve fibres and cause pain.
• Ligament spasms refer to an involuntary contraction or cramp that triggers a sharp pain.
• The pain may also occur by exercise or sudden movements that cause the ligaments to tighten quickly.
Precautions:
Some measures can be taken in order to prevent round ligament pain, such as:
• Avoid rapid or repetitive movements.
• Turning over or changing positions slowly.
• Using a heating pad.
• Wearing a maternity support belt.
• Flexing hips before sneezing or coughing.
• Doing prenatal yoga.
• Resting on one side, with knees bent and pillows supporting your belly and between your legs.
Treatment of Round Ligament Pain:
While the pain should be absolved completely after childbirth, there are ways to relieve the pain during pregnancy as well:
• Though no medication is required, over the counter acetaminophen can be taken for the pain.
• Exercise to keep the core muscles strong, doing stretching and prenatal yoga can be helpful.
• Flex and bend your hips before coughing, sneezing or laughing to avoid pulling on the ligaments.
• Use a heating pad or have a warm bath to relieve the pain.
• Modify your daily routine to avoid sudden movements that can worsen the pain.
• Rest more, put your swollen feet and ankles up and avoid getting up suddenly.
• Wear a belly band below your baby bump to reduce the pain.
• ( All the above should only be done on approval from your practitioner).
Severe pains:
Any pain during pregnancy should be reported to the doctor just to be safe. Round ligament pain is quick and harmless, contact your health care provider in case of severe pains that last longer than a few minutes, fever, chills, pain during urination, and difficulty in walking.
Pain due to stretching of uterine ligaments can be uncomfortable, but acute abdominal pain can be caused by many different causes. It is important that your doctor rules out serious conditions like pregnancy complications (like abortion) or non-pregnancy illnesses (inguinal hernia for example). It can be due to:
• Appendicitis is an inflammation of the appendix, symptoms include poor appetite, nausea, fever, and pain that progressively gets worse.
• Ovarian torsion or cysts may rupture or twist, causing severe abdominal pains.
• Abnormal growths in the abdomen
• Twisting of a fibroid tumour which can cause pain by interrupting the blood supply to the lesion.
• Constipation due to the slowing down of digestion during pregnancy.
• Stomach, liver, and kidney problems.
• Preterm labour pains can be mistaken for round ligament pain. Four contractions per hour can be a sign of labour.
Summary:
1. Round ligament pain is caused by stretching of the tissues that support the uterus.
2. The sharp pain is common and often begins in the 2nd trimester, on the right side of the lower abdomen.
3. It can be due to the cramping of these tissues and is normal, but precautions can be taken to prevent this pain.
4. The pain can be the result of other causes too and should be shown to a doctor if it does not resolve by itself and is severe.
