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What causes upper abdominal pain during pregnancy?

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Posted on Mon, 23 Mar 2015
Question: I am 6 weeks pregnant (from last period) and have had significant upper abdominal pain (dull to sharp, contant pain just under my rib cage which tends to increase at night) for the past three days. Last night it was severe enough to wake me up and it seemed to move down my back. I have no bleeding. Should I be concerned about miscarriage or ectopic pregnancy? My doctor is on vacation; should I go to outpatients at the hospital?
doctor
Answered by Dr. Ramadevi Wani (1 hour later)
Brief Answer:
Not ectopic or miscarraige. But needs assessment

Detailed Answer:
Hi,

Welcome to Healthcare magic.
I am Dr Ramadevi wani. I will be answering your concerns.

Is the pain on right side or left side? Do you have fever, vomiting or urinary complaints?
This constant pain under rib cage can be due to gallstones. If the stone blocks the duct from gall bladder to pancreas then you can experience this pain moving down your back.
The pain can be due to kidney stones also. It is not the pain of indigestion. In that case you would have had bloated abdomen, diarrhea etc.

It is NOT miscarriage or ectopic pregnancy.
In miscarriage the pain is in the middle of lower abdomen and pelvis and is often associated with spotting or bleeding per vagina.
In ectopic pregnancy the pain starts in the right or left lower abdomen. Later when the ectopic pregnancy leaks/bursts the pain may spread to upper abdomen and then it is extremely unbearable and often associated with vomiting.

Although the pain is not suggestive of ectopic or miscarriage you should go to the outpatients/ ER at the hospital to find the cause for pain and get treated.
I hope I have answered your concerns. If you have any further queries do write to me through Healthcare magic. I will be happy to answer.
Above answer was peer-reviewed by : Dr. Raju A.T
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Follow up: Dr. Ramadevi Wani (1 hour later)
Thank you for your answer. At what point in pregnancy (how many weeks past last period) would an ectopic pregnancy typically rupture? I am glad that you feel it is not ectopic, however! I also have some shooting pelvic pains (happens on either side or middle, rather than one sided) but they are not that frequent. In the past hour, my right upper arm has started aching. I do not have vomiting or fever, however. I have to urinate more frequently than usual but I don't think anything else is out of the ordinary.
doctor
Answered by Dr. Ramadevi Wani (4 hours later)
Brief Answer:
You need to be examined. Go to the emergency unit in hospital.

Detailed Answer:
Hi,

At what week an ectopic ruptures depends on where it is located in the tube. If it is situated in the lateral part of tube ( isthmus or near fimbria) it may rupture/leak from 6 weeks onwards. This is the commonest location for an ectopic.If it is located in the medial part of the tube it usually ruptures later, i.e. after 12 weeks of pregnancy.
Yes it is true that you may normally urinate more frequently in pregnancy.

Shooting pelvic pain is suspicious of ectopic pregnancy. The right upper arm pain you are mentioning did it start at the shoulder tip? This can occur in rupture of ectopic pregnancy. Are you having any black outs ( fainting attacks)? If so please go to the ER urgently.
If you are otherwise fit, take 2 paracetamol tablets and apply some cold compress on the arm. If the pain doesn't subside in 30 minutes then again it is serious.
I hope I have answered your concerns. If you have any further concerns, do write to me.
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Ramadevi Wani (50 minutes later)
The pain started a little lower than my shoulder tip and spread upwards. It lasted less than 30 minutes and is gone now. My abdominal pain has also decreased this evening, but is not completely gone. The shooting pains are brief, lasting only seconds, and are sudden and make me 'jump' a little. I also experienced one during intercourse. They are infrequent. I do not feel at all faint but will go to emerg tomorrow morning (or tonight if things get worse again). So to clarify, these symptoms I've described, although not one-sided, can still signal ectopic pregnancy? What are the chances of ectopic without bleeding? Is it ever normal to have shooting pelvic pains during early pregnancy?
doctor
Answered by Dr. Ramadevi Wani (39 minutes later)
Brief Answer:
Get an ultrasound done to know the location of pregnancy

Detailed Answer:
Hi,
Although your abdominal pain is decreased, brief shooting pains, especially the one you experienced after intercourse make me suspect the possibility of minimal trickling from ectopic pregnancy.

In up to 30 % of ectopic pregnancies there is no vaginal bleeding.
It is not normal to have shooting pelvic pains ( which make you jump) in pregnancy.

It is extremely important that you see doctor and have an ultrasound done to know the location of pregnancy.
Do you have any further queries. If so do write to me through Healthcare Magic.
Above answer was peer-reviewed by : Dr. Prasad
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Dr. Ramadevi Wani

OBGYN

Practicing since :1985

Answered : 1324 Questions

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What causes upper abdominal pain during pregnancy?

Brief Answer: Not ectopic or miscarraige. But needs assessment Detailed Answer: Hi, Welcome to Healthcare magic. I am Dr Ramadevi wani. I will be answering your concerns. Is the pain on right side or left side? Do you have fever, vomiting or urinary complaints? This constant pain under rib cage can be due to gallstones. If the stone blocks the duct from gall bladder to pancreas then you can experience this pain moving down your back. The pain can be due to kidney stones also. It is not the pain of indigestion. In that case you would have had bloated abdomen, diarrhea etc. It is NOT miscarriage or ectopic pregnancy. In miscarriage the pain is in the middle of lower abdomen and pelvis and is often associated with spotting or bleeding per vagina. In ectopic pregnancy the pain starts in the right or left lower abdomen. Later when the ectopic pregnancy leaks/bursts the pain may spread to upper abdomen and then it is extremely unbearable and often associated with vomiting. Although the pain is not suggestive of ectopic or miscarriage you should go to the outpatients/ ER at the hospital to find the cause for pain and get treated. I hope I have answered your concerns. If you have any further queries do write to me through Healthcare magic. I will be happy to answer.