Shoulder pain in early pregnancy
by Nathan Wei, MD, FACP, FACR
Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.
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One cause of shoulder pain in early pregnancy is ectopic pregnancy.
Any pregnancy which does not implant in the uterus may be categorized as ectopic.
If a pregnancy begins at the junction of the tube and upper uterus, at the cervix or ovary or anywhere in the abdominal cavity, it is said to be an ectopic pregnancy.
The early pregnancy signs and symptoms are similar to those of an early ectopic pregnancy. The period is usually late but there may be some vaginal bleeding or spotting. Symptoms of pregnancy such as breast tenderness, nausea and fatigue may be present. Some women develop pelvic cramping or abdominal pain. As the pregnancy advances, shoulder pain or signs of blood loss such as dizziness or faintness may develop.
Obstetricians caution women to watch for pain and bleeding, as these may indicate an ectopic pregnancy. If there is a suspicion, lab tests and ultrasound are requested.
Human Chorionic Gonadotropin (Beta hCG) levels may aid in the diagnosis. Low levels of beta HCG can be found in ectopic pregnancy.
A skilled ultrasonographer is usually able to identify markers of ectopic pregnancy.
Treatment of ectopic pregnancy depends upon the mother's condition, the gestational age of the pregnancy and whether or not rupture has occurred. Either surgical or medical treatment may be appropriate.
Medications may be administered, which abort the pregnancy safely. In other more advanced cases, surgery would be required. If the tube has ruptured, surgery is required.
If ectopic pregnancy is suspected, rapid diagnosis and treatment is essential to save lives and protect future fertility.
To reiterate the common signs and symptoms:
• 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
• Low blood pressure
• Lower back pain
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