Some Causes and Features of Pelvic Pain During Early Pregnancy
Cause |
Common Features* |
Tests† |
Pregnancy-related (obstetric) disorders |
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An ectopic pregnancy (an abnormally located pregnancy—not in its usual place in the uterus) |
Abdominal or pelvic pain that If the ectopic pregnancy has ruptured, possibly fainting, light-headedness, or a racing heart |
A blood test to measure a hormone produced by the placenta (human chorionic gonadotropin, or hCG) Ultrasonography of the pelvis Sometimes laparoscopy (insertion of a viewing tube through an incision in the abdomen) or laparotomy (surgery involving an incision into the abdomen) |
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A miscarriage that |
Crampy pain in the pelvis and often throughout the abdomen Often vaginal bleeding, sometimes with passage of tissue from the fetus |
Tests as for ectopic pregnancy |
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Septic abortion (infection of the contents of the uterus before, during, or after a miscarriage) |
Usually in women who have had an abortion (often done by untrained practitioners or by the women themselves) Fever and chills, constant abdominal or pelvic pain, and a vaginal discharge that contains pus |
Ultrasonography of the pelvis Cultures of a sample taken from the cervix (the lower part of the uterus) |
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Normal changes of pregnancy, including stretching and growth of the uterus during early pregnancy |
A crampy or burning sensation in the lower abdomen, pelvis, and/or lower back |
Ultrasonography of the pelvis |
Gynecologic disorders unrelated to the pregnancy |
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Degeneration of a fibroid in the uterus |
Pelvic pain that Sometimes vaginal bleeding |
Ultrasonography of the pelvis |
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Adnexal torsion (twisting) of an ovary |
Pelvic pain that Often nausea or vomiting |
Doppler ultrasonography (to evaluate blood flow to and from the ovary) Sometimes laparoscopy or laparotomy |
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Rupture of a corpus luteum cyst (which develops in the structure that releases the egg after the egg is released) |
Abdominal or pelvic pain that Vaginal bleeding |
Ultrasonography of the pelvis Sometimes laparoscopy or laparotomy |
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Pelvic inflammatory disease (which is uncommon during pregnancy) |
Pelvic pain that A vaginal discharge that contains pus Sometimes fever or chills More common among women who have sexual intercourse with new partners and do not use condoms or diaphragms |
Cultures of a sample taken from the cervix Sometimes ultrasonography of the pelvis |
Other disorders |
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Usually continuous pain and tenderness in the lower right part of the abdomen Possibly pain in a different location (for example, higher in the abdomen) or a different kind of pain (milder and crampy) from that in people who are not pregnant |
Cultures of a sample taken from the cervix Ultrasonography of the pelvis and abdomen Possibly CT if ultrasonography is inconclusive |
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Discomfort felt in the area over the pubic bone Often burning during urination, an urge to urinate often (frequency), and a need to urinate immediately (urgency) Sometimes blood in urine |
Urine tests (urinalysis) and culture |
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Inflammatory bowel disease including |
Pain that Often diarrhea that sometimes contains mucus or blood Usually in women known to have the disease |
Sometimes endoscopy of the upper digestive tract, lower digestive tract (sigmoidoscopy or colonoscopy), or both |
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A blockage in the intestine (intestinal obstruction) |
Cramping pain that comes and goes Vomiting No bowel movements or gas (flatulence) A swollen abdomen Usually in women who have had abdominal surgery |
Cultures of a sample taken from the cervix Ultrasonography of the pelvis and abdomen Possibly CT if ultrasonography is inconclusive |
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Usually vomiting and diarrhea |
A doctor's examination |
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*Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. |
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†A urine pregnancy test is typically done if women have had only a home pregnancy test. Because an ectopic pregnancy can be very dangerous, tests are done to look for ectopic pregnancy in most pregnant women with pelvic pain, unless symptoms clearly point to another disorder (such as gastroenteritis). |
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CT= computed tomography. |
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