Xiao Wang is 34 years old and had frequent habitual miscarriages in the previous years, and every time the embryo withered before she could enjoy the sweet pain of pregnancy vomiting. The next three years of infertility made her experience what it means to suffer one after another. In the middle of May this year, her period did not arrive, so she rekindled her hope for motherhood. The sky did not disappoint, although this pregnancy is a birth control, stumbling also maintained for more than 6 months, during the many times lower abdominal cramps have been resolved. On the 20th of this month, the mother-to-be, who was 27+ weeks out of menstruation, had another episode of lower abdominal cramping and, unlike before, occasional lower abdominal paroxysms and increased vulvar discharge, and the working woman wanted to hold on until the weekend before going to hospital to keep the baby. To her great disappointment, when the weekend came, the hospital arrived and the water sac wrapped around the fetus had come off to the cervical opening. The doctor told her that miscarriage was inevitable and that she had lost the best time to keep the baby. Abdominal pain during pregnancy is one of the most common discomforts encountered by pregnant mothers and often afflicts mothers-to-be. Once the abdominal pain, most of them will immediately seek medical advice and get timely and correct treatment; but there are still a few pregnant mothers, regardless of the situation, and simply take a wait-and-see attitude, sometimes delaying the opportunity to make a big mistake. A, physiological abdominal pain during pregnancy 1, the uterus increases, ligament pulling causes lower abdominal dull pain: pregnant, the uterus is obviously congested and gradually increased, usually used to fix the position of the uterus 4 pairs of ligaments – the main ligament, sacral ligament, broad ligament and round ligament, sometimes subject to pulling shaking or sudden displacement and produce pain and discomfort. In early pregnancy, the pain is usually dull, vague or pulling pain, stabbing and throbbing pain in the middle or both sides of the lower abdomen, or low back pain, each episode is brief, mild and tolerable, without vaginal bleeding and without painful emotional reactions. In mid-pregnancy, the main manifestation is transient dull pain on both sides of the lower abdomen without fever and vomiting and diarrhea, with occasional pressure pains felt in the round ligament of the uterus, mostly during position changes or long-distance walking, and relieved after bed rest. In some cases, the pain is caused by the fetus kicking in the mother’s womb. In late pregnancy, the increasing uterus constantly stimulates the lower edge of the rib cage, which can cause dull pain in the rib cage, clinically manifested as one-sided or bilateral epigastric pain, with left upper abdominal pain being common. 2.Braxton Hicks contraction pain: From 12 to 14 weeks of pregnancy, the uterus develops irregular painless contractions, which can be detected by palpation during abdominal examination and sometimes felt by the pregnant woman herself. Although the intensity and frequency of contractions increase gradually with the progress of pregnancy, the pressure in the uterine cavity does not exceed 1.3-2.0 kPa during contractions, so there is no pain and the duration does not exceed 30 seconds. However, in late pregnancy, when the mother rests at night, the contractions become stronger and occasionally cause lower abdominal pain. However, the pain is not accompanied by cervical dilatation and there is no increase in vaginal discharge, so it can be distinguished from preterm labor aura. Although the above mentioned pain is a physiological phenomenon that has no obvious adverse effects on the fetus in the womb and the mother’s body, there is no need to worry about it; however, it should still be emphasized that the so-called physiological abdominal pain during pregnancy is only distinguished from pathological abdominal pain during pregnancy in terms of the cause of the pain. For example, Braxton Hicks contractions (pain), which can cause miscarriage and preterm labor if further intensified, are often identified by doctors only after relevant examinations or dynamic observation. Do not take it upon yourself to delay the timely diagnosis and treatment of pathological abdominal pain during pregnancy by covering the whole picture with bias. The former manifests as a small amount of vaginal bleeding within 7 months of pregnancy, often less than the amount of menstruation, the blood color is mostly bright red, sometimes accompanied by lower abdominal pain, lumbago and falling sensation, lower abdominal cramping pain, etc., which indicates a preterm abortion. At this time, mothers-to-be should be less active, rest properly, do not have intercourse, do not lift heavy objects, hydrate, and seek medical attention promptly. If the pain worsens or bleeding persists, you should seek immediate medical attention. A few cases with rotten flesh-like tissue discharge are incomplete miscarriages, and there is always a risk of hemorrhage and infection, so you should go to the hospital immediately to remove the uterus. The latter is characterized by lower abdominal paroxysmal pain, or cramping pain with or without a little bloody vaginal discharge after 7 months. Sometimes there is uncertainty and debate among doctors as to whether the lower abdominal pain that occurs in the middle and late stages of pregnancy is physiological or pathological, or whether medical intervention is needed. The prudent management measures are: firstly, to find the cause and causative factors and to admit the patient to hospital for observation as pathological abdominal pain during pregnancy; secondly, for pregnant women with lower abdominal pain at 24-35 weeks of menopause, ultrasound measurement of the length of the cervix and special reagents to detect the concentration of fFN in cervical secretions are used to differentiate the treatment. If the length of the cervix is 3.0 cm or more on vaginal ultrasound, the fetal fibronectin (fFN) is negative, and there is no case of miscarriage or preterm delivery within 14 days, that is, no medical intervention is needed, otherwise, treatment with contraction inhibitors is recommended. Ectopic pregnancy (commonly known as ectopic pregnancy): most of these pregnancies occur within the third month of pregnancy, often without vomiting. The main manifestation is irregular, small amount of vaginal bleeding of dark red color after menopause. Early placental abruption: It often occurs in high-risk pregnant women who have a history of hypertension, or prefer to stay in bed for a long time, or have direct trauma to the abdomen, manifesting as sudden vaginal bleeding after 5 months of pregnancy, persistent mild or severe abdominal pain, distended and hardened abdomen, obvious pain when pressed, often accompanied by nausea and vomiting, dizziness and pallor. The above abdominal pain is often accompanied by intra-abdominal bleeding, which threatens the life of mother and fetus in serious cases and requires rapid hospitalization for rescue treatment. 2, pathological abdominal pain not related to pregnancy These abdominal pains are not directly related to pregnancy, but are often affected by pregnancy, making diagnosis and treatment more difficult, so they need more attention! Acute appendicitis: It is characterized by pain in the upper abdomen or around the umbilicus at the beginning of the disease, vomiting, sometimes an increase in the number of stools with fever. Because of the enlargement of the uterus during pregnancy, the appendix is displaced to the upper right side, so the clinical manifestations may not be typical. Gallstone and cholecystitis: After pregnancy, pregnant mothers are prone to gallstones because of the relative saturation of cholesterol in their blood and bile. Cholecystitis and cholelithiasis can occur at any stage of pregnancy, but mostly in late pregnancy and puerperium, where lying down at night makes the stones embedded in the common bile duct and more likely to induce painful attacks. The pain is often accompanied by fever, chills, nausea, vomiting and other symptoms. If there is gallstone disease before pregnancy, the slightest carelessness will easily lead to gallbladder inflammation. The mother-to-be should pay attention to chewing slowly, should not eat a meal too full, eat less fatty foods, especially dinner avoid overeating. Acute pancreatitis: Pregnancy induced hyperlipidemia makes pregnant women more susceptible to acute pancreatitis than normal people, manifesting as sudden onset of severe pain in the upper abdomen, band-like distribution, back pain, often occurring after a full meal, accompanied by fever, nausea, vomiting, peritonitis and shock can occur in severe cases. The above abdominal pain, because of the severe pain, critical condition, often bring serious health risks to the mother-to-be, if the mother-to-be usually pay attention to diet and hygiene, work and rest, peace of mind, sleep, prenatal check-ups on schedule and follow medical advice, most of the above painful diseases can be avoided.