Non-pregnancy related pain
What are the causes of pain (in pregnancy) that are not pregnancy-related?
As we mentioned before, no list can be exhaustive; below, we cover the causes encountered more commonly. Pathological conditions which are incidental in pregnancy (i.e. which may have similar symptoms in a non-pregnant state) include:
Urinary tract infection (UTI)
Gallbladder inflammation (cholecystitis) or stones
Torsion of ovarian cyst
Inflammatory bowel disease
It looks like a long list of causes!
Yes, and this is by no means everything, all the more reason why an expectant mother should refrain from making her own diagnosis. It is important that any pain in pregnancy is assessed by an expert, to rule out disease. Some causes, such as appendicitis or urinary tract infection, will require immediate treatment, while others (such as gallstones) may be managed conservatively in pregnancy.
Pain in pregnancy is, in most cases, innocent. In other cases, it is not, and an expert should be allowed to make the distinction.
How common is appendicitis in pregnancy?
The susceptibility is neither increased nor decreased by pregnancy. One in every 2,000 (two thousand) pregnancies will be complicated by appendicitis.
A correct diagnosis is very important, as fetal loss is quite high if the appendix perforates. The mother's life is also endangered by appendix rupture.
How common are gallstones in pregnancy?
Gallstones are generally uncommon in the teens and twenties. The condition becomes more common from the mid-thirties. Obesity is a predisposing factor even at a younger age. Pregnancy clearly makes pre-existing gallstones worse and symptoms may appear for the first time in pregnancy. Moreover, this may be complicated by inflammation of the gallbladder, a condition seen in 0.1 per cent of all pregnancies (1 in 1000).
As mentioned before, gallstones in pregnancy are usually managed conservatively, but sometimes an operation becomes necessary. It is important to be aware of the fact that gallstones predispose to acute pancreatitis, another important, albeit uncommon, cause of pain in pregnancy.
What about peptic (gastric) ulcers in pregnancy?
Peptic ulcers could be gastric or duodenal.
If one does not have a pre-existing peptic ulcer, it is extremely unlikely that this condition will develop for the first time in pregnancy. Moreover, peptic ulcer patients almost always experience improvement in their symptoms in pregnancy. Having said all that, perforation of a peptic ulcer has been known to occur during pregnancy.