Abdominal discomfort or cramping

Pain in the lower abdomen during the first and second trimesters often stems from normal pregnancy changes. As the uterus expands, the ligaments and muscles that support it stretch. This stretching may cause twinges, cramps or pulling sensations on one or both sides of your lower abdomen. You may notice the pain more when you cough, sneeze or change position.

Another fairly common cause of abdominal or groin discomfort in midpregnancy is stretching of the round ligament, a cord-like muscle that supports the uterus. The discomfort usually lasts for several minutes and then goes away. (See also Round ligament pain.)

If you've had abdominal surgery, you may have pain from stretching or pulling of adhesions, the bands of scar tissue that adhere to the walls of the abdomen or other structures. The increasing size of your abdomen can cause these bands of tissue to stretch or even pull apart, which can be painful.

Lower abdominal discomfort that's relatively minor and comes and goes irregularly is probably nothing to worry about. If it's regular and predictable, consider whether you might be entering labor, even if you are still far from your due date.

■ Prevention and self-care for abdominal discomfort or cramping

It may help to sit or lie down if abdominal pain is bothering you. You may also find relief by soaking in a warm bath or doing relaxation exercises.

■ When to seek medical help for abdominal discomfort or cramping Pain that's severe and unrelenting may be a sign of a problem, such as ectopic pregnancy or preterm labor. The first sign of an ectopic pregnancy usually is pain in the abdomen or pelvis. This pain is usually described as sharp and stabbing. Your abdomen may feel tender. You may have bleeding, nausea and low back pain.

In midpregnancy and beyond, lower abdominal pain accompanied by continuous low back pain or contractions may signal preterm labor. Call your health care provider right away if:

• Pain is severe, persistent or accompanied by fever

• You experience vaginal bleeding, vaginal discharge, gastrointestinal symptoms, dizziness or lightheadedness

• You have pain in the shoulder and neck

• You have contractions, which may feel like a tightening in the abdomen and a sensation similar to menstrual cramps

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