Early pregnancy symptoms low back pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a natinally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit



There are multiple causes of low back symptoms during early pregnancy.

Common

At least 50 percent of women experience back pain during pregnancy. Pregnant women are prone to backaches and back pain for a number of reasons:

Extra weight. The weight you gain during pregnancy is good for your baby, but it can be bad for your back.

Change in center of gravity. As your uterus grows, your center of gravity shifts forward. Gradually — and perhaps without notice — you begin to adjust your posture and the way you move. These compensations can lead to backaches and back pain.

Your hormones. During pregnancy, the hormone relaxin causes the ligaments between your pelvic bones to soften and your joints to loosen in preparation for your baby's passage through your pelvis during birth. As the structures that support your pelvic organs become more pliant, you may feel considerable discomfort on either side of your lower back, often with walking, especially up and down stairs.

Back pain can occur at any time during pregnancy. For many women, it interferes with daily activities and the ability to get a good night's sleep.

Ectopic pregnancy

If a woman has an ectopic pregnancy, she may experience the typical early pregnancy symptoms, including nausea and breast tenderness. Or, she may have no early symptoms at all and may not even realize that she is pregnant. About a week after the first missed menstrual period, one may notice:

• Slight vaginal bleeding that is usually brown in color. Women often mistake this bleeding for a normal menstrual period.
• Pain in the lower abdomen, felt mainly on one side.


If you experience these symptoms, especially if you know you are pregnant or suspects you might be, you should see a doctor right away. Unfortunately, the embryo cannot be saved in the nearly all ectopic pregnancy cases. However, prompt treatment can keep the fallopian tube from rupturing, saving your fertility and perhaps your life.

Without treatment, the symptoms of the ectopic pregnancy will worsen over several days or weeks. They include:

• Severe pelvic pain
• Shoulder pain caused by blood from a ruptured ectopic pregnancy pressing on the diaphragm, the large muscle that separates the abdominal and chest cavities
• Faintness or dizziness caused by blood loss
• Nausea
• Vomiting
• Low blood pressure
• Lower back pain

A ruptured ectopic pregnancy is a serious condition and can be life threatening. If you experience symptoms of an ectopic pregnancy, see your doctor or go to a hospital emergency room right away.

Preterm labor is usually defined as having regular contractions and dilation of your cervix before the 37th week of your pregnancy. This can either be done deliberately by your health care provider due to a pregnancy complication that you or your baby have developed, or it could be spontaneous.

Causes of this are:

• Abnormal placenta or even severe Cervix complications
• Genital tract infections. Bacteria may cause the sac to weaken and cause a premature rupture, which then would lead to a preterm birth
• Chronic maternal illnesses such as pre-gestational diabetes, sickle cell anemia, severe asthma etc.

The following risk factors are related to premature labor and can be controlled by you. Eliminating the ones that apply to you will give your baby the best chances of being carried to term (between 38 and 42 weeks).

• Smoking
• Alcohol use
• Drug abuse
• Inadequate weight gain
• Inadequate nutrition
• Gum infection
• Heavy physical labor
• Infection
• Hormonal imbalance
• Incompetent cervix or premature cervical effacement and dilation
• Uterine irritability
• Placenta previa
• Chronic maternal illness such as high blood pressure, heart, liver, kidney disease, or diabetes
• Extreme emotional illness
• Under age seventeen
• Over age thirty-five
• Low educational or socioeconomic level
• Structural abnormalities of the uterus or large fibroids
• Multiple gestations
• Fetal abnormality
• History of premature deliveries

Preterm labor is a very serious complication of pregnancy. Unfortunately, many women do not understand the signs of preterm labor. Early detection can help prevent premature birth and possibly enable you to carry your pregnancy to term or to give your baby a better chance of survival. If you experience any of the below signs or symptoms, be sure to contact your health care provider immediately:

• An increase of vaginal discharge especially a sudden gush of clear watery fluid from your vagina
• Spotting or bright red blood from your vagina
• Menstrual like cramping or more than 5 contractions in an hour
• Increase in pressure in the pelvic area
• Low back pain or pressure, or a change in the nature of lower backache
• Swelling or puffiness of the face or hands
• Painful urination, signifying urinary tract, bladder or kidney infection
• Acute or continuous vomiting
• Intense pelvic pressure

One of the first things that your practitioner will tell you to do if you are having contractions is staying very well hydrated. What happens with dehydration is that the blood volume decreases, therefore increasing the concentration of oxytocin (hormone that causes uterine contractions) to rise. Hydrating yourself will increase the blood volume. Others things that you can do would be:

• Pay attention to signs and symptoms of infections (bladder, yeast, etc.) because they can also cause infections
• Keeping all of your appointments with your practitioner and calling whenever you have questions or symptoms. A lot of women are afraid of jumping to conclusions but it is much better to be incorrect than to be in preterm labor and not being treated. Also, be sure to follow your practitioner’s recommendations as to limitations on strenuous activity, including sexual intercourse and hours spent on the job
• Getting good dental care
• Avoiding smoking, cocaine, alcohol, and other drugs not prescribed by your doctor
• Get tested for any infections, especially those of the genital tract

This being said, not all preterm births can be avoided, since not all are due to preventable risk factors.

The best key is always prevention and early detection. Make sure to ask your practitioner to discuss the signs and symptoms of preterm labor to you and your partner at your next visit. Prompt medical treatment is aimed at halting or postponing premature labor. Some of the treatments involved with preterm labor include:

• Hydration (Oral or IV)
• Bed rest (Home or Hospital), usually left side lying, limitations on sexual intercourse
• Medications. These are used either to stop labor, to prevent infection or to help your baby’s lung develop more quickly in preparation for the birth. Drugs that relax the uterus (tocolytic agents) may be administered to stop contractions.
• Evaluation of your baby (Biophysical profile, non-stress or stress tests, amniotic fluid volume index (AFI), ultrasound, etc.)
• If the mother and/or child are in imminent danger from illness or other problems, no attempt is made to prevent labor and child is delivered.


Hydatidiform mole

This is a gestational trophoblastic disease- a tumor- that encompasses several disease processes that originate in the placenta. These include complete and partial moles, placental site trophoblastic tumors, choriocarcinomas, and invasive moles.

Hydatidiform mole is more common at the extremes of reproductive age. Women in their early teenage or perimenopausal years are most at risk. Women older than 35 years have a 2-fold increase in risk. Women older than 40 years experience a 7-fold increase in risk compared to younger women. Parity does not affect the risk.

Complete mole: The typical clinical presentation of complete molar pregnancies has changed with the advent of high-resolution ultrasonography. Most moles are now diagnosed in the first trimester before the onset of the classic signs and symptoms.

Vaginal bleeding: The most common classic symptom of a complete mole is vaginal bleeding. Molar tissue separates from the decidua, causing bleeding. The uterus may become distended by large amounts of blood, and dark fluid may leak into the vagina. This symptom occurs in 97% of cases.
Hyperemesis: Patients may also report severe nausea and vomiting. This is due to extremely elevated human chorionic gonadotropin (HCG) levels.
Hyperthyroidism: Approximately 7% of patients may present with tachycardia, tremor, and warm skin.

Partial mole: Patients with partial mole do not have the same clinical features as those with complete mole. These patients usually present with signs and symptoms consistent with an incomplete or missed abortion.

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