Causes of dull abdominal pain at 35 weeks of pregnancy

At 35 weeks of pregnancy, the baby is about to be born. At this time, pregnant women are prone to abdominal pain and always feel a dull pain. There are two main reasons for this pain. One is physiological, which is a relatively normal abdominal pain. For example, it is caused by uterine contractions. Don't worry at this time, just strengthen your care. In addition, be alert to some pathological abdominal pain. Some measures should be taken in time.

1. Abdominal pain in late pregnancy: Physiological abdominal pain

1. The enlarged uterus compresses the ribs and causes abdominal pain

As the baby grows, the expectant mother's uterus also gradually expands. The enlarged uterus constantly stimulates the lower edge of the ribs, which can cause dull rib pain in expectant mothers.

How to deal with it: This is physiological and does not require special treatment. Lying on the left side can help relieve pain.

2. Abdominal pain caused by false labor

In the late pregnancy, false labor may cause mild distension and pain in the lower abdomen. It often occurs in the dead of night and disappears at dawn. The frequency of contractions is inconsistent, the duration is not constant, the intervals are long and irregular, the intensity of contractions does not gradually increase, and there is no feeling of falling, and the symptoms are relieved during the day.

How to deal with it: False labor indicates that the pregnant woman will soon go into labor, so she should be prepared, such as getting enough rest, eating more high-energy foods such as chocolate, and conserving her energy. At the same time, you need to be familiar with the fetal movement pattern before delivery: the uterine contractions before delivery are rhythmic, and each contraction goes from weak to strong, lasting for a period of time, generally 30-40 seconds, and then disappears and enters an interval period of 5-6 minutes.

3. Fetal movement causes abdominal pain

Fetal movements are most noticeable between 28 and 32 weeks. At 20 weeks, the average number of fetal movements per day is about 200, which increases to 375 at 32 weeks. The number of fetal movements per day may range from 100 to 700. After 32 weeks, the fetus gradually occupies the space in the uterus, and his (her) space for movement will become smaller and smaller, but he (she) will occasionally still kick you very hard. When his or her head hits the muscles of your pelvic floor, you will suddenly feel like you have been hit hard.

How to deal with it: Self-test fetal movement. Starting from the 28th week of pregnancy, count the fetal movements three times a day, morning, noon and evening, for one hour each time. Add the total and multiply by 4 to get the fetal movements in 12 hours. If the fetal movement is ≥30/12 hours or ≤3 times/hour, it is normal.

2. Abdominal pain in late pregnancy: pathological abdominal pain

1. Placental abruption

The incidence of placental abruption in the late pregnancy is 0.5-1%, and it is more common in pregnant women with high blood pressure, smoking, and multiple births. The pain caused by placental separation is usually severe tearing pain in the lower abdomen, often accompanied by vaginal bleeding. The degree of abdominal pain is affected by a combination of factors such as the size of the abruption area, the amount of blood, the internal pressure of the uterus, and whether the uterine muscle layer is damaged. In severe cases, the abdominal pain is unbearable, the abdomen becomes hard, the fetal movement disappears, and even shock may occur. When the placenta is detached by more than 50%, it usually causes abnormal coagulation mechanism of the pregnant woman and fetal death.

Countermeasures: Strengthen prenatal examinations, actively prevent and treat pregnancy-induced hypertension; strengthen management of high-risk pregnancies with hypertension, chronic nephritis, etc.; when performing external version to correct abnormal fetal position, the operation must be gentle. In the late stages of pregnancy, expectant mothers with high blood pressure or abdominal trauma should go to the hospital in time to prevent accidents.

2. Threatened uterine rupture

Uterine rupture refers to the rupture of the uterine body or lower segment in late pregnancy or during delivery. It is an obstetric complication that directly threatens the life of the pregnant woman and the fetus. Uterine rupture is more common in patients with previous uterine injuries, such as pregnant women who have undergone cesarean sections or myomectomy. The incidence of uterine rupture is approximately 2%. Most cesarean sections today use a low-level transverse incision, which is relatively strong but also has the possibility of rupture. Uterine rupture may cause shock, hypoxia and death to both the pregnant woman and the fetus due to heavy bleeding. Uterine rupture is one of the common causes of maternal mortality.

Uterine rupture often occurs in an instant. Before that, pregnant women feel continuous severe pain in the lower abdomen, extreme restlessness, flushed face, and rapid breathing. This is a precursor to uterine rupture. Uterine rupture causes instantaneous tearing pain. After rupture, uterine contractions stop and the pain can be relieved. As blood, amniotic fluid, and fetus enter the abdominal cavity, the abdominal pain continues to worsen. Pregnant women have rapid breathing, pale face, weak pulse, and lowered blood pressure, falling into a state of shock.

How to deal with it: If severe abdominal pain occurs, seek medical attention immediately. Once the uterus is confirmed to be ruptured, the expectant mother should undergo a caesarean section as soon as possible. In order to save the life of the parturient, the operation time should be shortened as much as possible and the operation should be as simple and quick as possible to achieve the purpose of hemostasis. If the fetus is found to still have a heartbeat before a caesarean section, it means the fetus has a high chance of survival. Whether total hysterectomy or subtotal hysterectomy or only rupture suture plus bilateral tubal ligation can be performed depends on the specific circumstances. Large doses of effective antibiotics were used before and after surgery to prevent infection.