Severe Abdominal Cramps During Pregnancy: Causes & Relief

Question
Dear Dr Rappaport,
I am 30, 1st pregnancy, first day of my last period was April 22 2004.

I have been suffering with severe lower abdominal pains which last approx 25-30 mins in duration, and occur in the middle of the night when I get up to urinate and in the morning when I get out of bed.  Sometimes the pain awakes me and I dont need to urinate.  

I also feel the pain approx. twice in the daytime but with less intensity. Sometimes walking can set off the pain too. The pain radiates down my legs and hurts in my lower back too.  My doctor does not know what it is, UTI has been ruled out.  

The intensity, duration, and frequency has not changed since it started about 12 days ago.  The pains are much worse than any period pains I have experienced, and are not accompanied by blood.  I feel like I am getting no answers from my doctor, and the pain is interfering with my ability to attend work.  

I would greatly appreciate your views on this, i live in the UK, therefore I have no access to ob-gyn, until my 12th week when I go for a scan and tests.  Obviously, I can go to emergency if I need to but the pains come and go so i dont need to yet.

Yours sincerely,

Marianne Kerti

Answer
If the first day of your last period was April 22, then you were due for your period on May 19. Today is May 30. You claim that the pain started 12 days ago, just before you were due for your period. Therefore, you are now appoximately 5 weeks 4 days pregnant. As long as you are not having any vaginal bleeding, it is doubtful that you are having a miscarriage. If the pain radiates down yhour legs and to your lower back, it may be due to stretching of some of the ligaments that are attached to the uterus. Often "round ligament syndrome" occurs (pain in the lower abdomen, near the groin) upon rising or sudden turning due to stretching of the round ligaments. There are other ligaments and bands that can be stretched, causing such pain. If a urine culture has ruled out UTI, I would only use mild analgesics (Tylenol, etc) until at least 7 weeks gestation when you can get a sonogram that will show the feteus and a fetal heartbeat. Heating pads and showers may help alleviate the pain as well.