Pregnancy Cramps: Should You Be Worried?

See Your Physician If Your Cramping Is Bad

Having cramps
Getty Images/Eva Katalin Kondoros

When you become pregnant after having had a miscarriage, early pregnancy cramps can be a matter of anxiety. Is it just normal uterine stretching and growth, or is it a sign of impending miscarriage? The answer isn't always obvious, but here are some pointers to keep in mind when deciding what to do.

Abnormal Pregnancy Cramps

Always see your physician if your cramping is persistent or severe. Severe cramping in particular should always be investigated in order to rule out ectopic pregnancy.

If you think you have signs of a ruptured ectopic pregnancy, go to the emergency room right away. Also, if your cramping seems to be focused on one side of your lower abdomen, call your physician to be on the safe side even if the cramping isn't severe; one-sided pain can also be a sign of ectopic pregnancy.

If you are having any kind of vaginal bleeding alongside the cramping in early pregnancy, you should call your physician--it's possible that you might be having a miscarriage. These symptoms don't always mean miscarriage, but your physician should be able to order hCG blood tests or an ultrasound to figure out what's going on.

Normal Early Pregnancy Cramps

Even though cramps can sometimes indicate problems, cramping in pregnancy is probably normal more often than not. As your uterus begins to grow, you can feel mild to moderate cramping in your lower abdomen or your lower back. This cramping may feel like pressure or stretching, or it may feel similar to menstrual cramping, but mild, transient cramping in early pregnancy is usually normal and not a sign of miscarriage.

Mention it to your physician at your next prenatal appointment, but there's probably no immediate cause for concern if the pain isn't severe, isn't one-sided, and is not accompanied by bleeding.

Cramps in Later Pregnancy

Abdominal cramps can occur later in pregnancy also as the uterus grows larger, but be on the lookout for signs of preterm labor, and always let your physician know right away if you are having severe pain or bleeding alongside the cramping.

Ectopic Pregnancy Explained

One serious reason that a person may be experiencing cramping during pregnancy is ectopic pregnancy.

Usually, the fertilized egg implants onto the wall of the uterus. When the egg implants outside of the uterine cavity, this condition is called an ectopic pregnancy. Ectopic pregnancy usually occurs in one of the fallopian tubes. Remember that the fallopian tubes carry the egg from the ovary to the uterus.

An ectopic pregnancy is a nonviable pregnancy. In other words, there's no way that an ectopic pregnancy can result in a baby. The fallopian tubes or wherever else the egg implants lacks the tissues necessary for the embryo to develop into a fetus. Instead, an ectopic pregnancy can destroy the surrounding structures. For example, ectopic pregnancy can rupture the fallopian tubes. A ruptured fallopian tube will lead to extreme pain, lightheadedness, and even life-threatening shock. A ruptured fallopian tube requires immediate surgery. Fortunately, if caught early enough, ectopic pregnancy can be treated with methotrexate.

Sources:

Abdominal Pain or Cramping. March of Dimes. Accessed: Oct. 21, 2009

Pregnancy FAQ: Early Pregnancy. American Pregnancy Association. Accessed: Oct. 20, 2009

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