Pain in the right side during pregnancy is the appearance of unpleasant sensations that can occur at any stage. There can be many reasons for such pain, so you should take any painful sensations during pregnancy seriously, because we are talking about two lives. To be sure that nothing is in danger for mother and child, you need to consult a doctor.

Causes of pain in the right side during pregnancy

There can be many reasons for the development of pain of this localization during pregnancy. First of all, you need to know about the gestational age. Pain in the right side, as a sign of pregnancy, is very common. They occur after a fertilized egg implants in the uterine cavity. This often happens in the right horn of the uterus, which is accompanied by the process of dissolution of the endometrium for normal implantation. Nerve endings may be involved in this process, so when a woman has slight physical activity, she may feel pain in her right side, the site of egg implantation. Therefore, this may even be one of the indirect signs of pregnancy itself, if the woman does not yet know about it.

As for other etiological factors for the appearance of pain in the right side during pregnancy, they depend on the duration of pregnancy. During pregnancy, the uterus increases every week to a certain size, which can cause compression of the internal organs and provoke the appearance of various symptoms. The right side flank of the abdomen contains the liver, gall bladder, small and large intestines, right kidney, and appendix. The pathogenesis of the appearance of symptoms is due to the fact that the enlarged uterus puts pressure on these organs, which is the cause of the appearance of certain unpleasant sensations. When these organs are compressed, blood circulation and normal innervation may be disrupted, and various symptoms may appear associated with this pain syndrome. This condition occurs in the third trimester of pregnancy, when the uterus reaches such a size that it can cause compression.

Among other causes of such pain, inflammatory diseases can be called first. During pregnancy, all chronic diseases tend to become more active due to a decrease in immune defense. Therefore, pregnancy itself is a risk factor for exacerbation of chronic cholecystitis. Then the pain is caused by inflammation of its wall and irritation of the peritoneum. If cholecystitis is calculous, then often a change in the location of the gallbladder due to compression by the uterus can cause the movement of stones, so the etiological factor for acute pain in this localization may be hepatic colic. If a woman has liver problems, this can also lead to pain during pregnancy. The liver carries out the load for both the child and the mother, so with additional physical activity, its capsule can become tense, which causes pain in the right side.

Disruption of peristalsis and normal bowel function can also be manifested by pain in the right side. After all, compression of the small and large intestines leads to the fact that not only their peristalsis is disrupted, but over time the biocenosis is also disrupted – which subsequently affects the symptoms. Inflammation of the intestines after poisoning in the form of acute enteritis or enterocolitis often causes similar pain in the right side, since the enlarged uterus displaces the intestines. Therefore, the pain has exactly this localization.

During pregnancy, the location of the kidneys and ureters is disrupted; they rise higher, so inflammatory or mechanical disorders in these organs can lead to irradiation of pain. Often right-sided pyelonephritis in pregnant women is accompanied by right-sided pain as the first sign of the disease. At the same time, the kidney capsule also stretches and this leads to pain in the side. It is also worth excluding renal colic as the cause of such pain.

The most serious cause in terms of possible complications is considered to be inflammation of the appendix – acute appendicitis. It is localized on the initial part of the cecum, which is located in the right iliac region. But this colon does not have a large mesentery, so it is very dynamic. Often in pregnant women, the appendix changes its location and can be under the liver, and even near the right kidney. But the pain radiates when the peritoneum is irritated and is always located on the right, so you should not forget about appendicitis, because pregnancy itself does not exclude the possibility of acute appendicitis, but on the contrary predisposes to it.

In late pregnancy, there may be premature placental abruption, which is caused, for example, by preeclampsia. This condition is accompanied by an increase in blood pressure in a woman, which is often complicated by placental abruption. If it occurs on the right side of the uterus, it may cause pain in the side.

An ectopic pregnancy that develops in the right fallopian tube, when it ruptures, can manifest itself as symptoms of right-sided pain. This is important to consider, because sometimes a woman may not yet know about pregnancy.

Risk factors for pain in the right side during pregnancy

Given the variety of causes of pain in the right side in pregnant women, it is necessary to carefully diagnose all symptoms in order to accurately determine the etiology of this pain and determine the need for treatment. The main risk factors must be taken into account during prevention:

  • chronic calculous cholecystitis in a woman before pregnancy should be treated prophylactically during the period of planning a child;
  • liver disease in women;
  • urolithiasis disease;
  • chronic enteritis and enterocolitis;
  • late gestosis of pregnant women.

    • Epidemiology of pain syndrome during pregnancy

    The epidemiology of the spread of pain during pregnancy is very wide. About 96% of pregnant women experience abdominal pain in the third trimester of pregnancy, and 65% of this pain is localized to the right side. Such pain is not always the cause of an organic disease; only 72% is a pathology. Among these diseases, pathology of the liver and gallbladder is in first place, acute appendicitis, as well as chronic intestinal diseases, are in second place. But nevertheless, it is necessary to carefully carry out differential diagnosis, because all these pathologies can be complicated.

    Symptoms of pain in the right side during pregnancy

    To know what causes such pain in a pregnant woman, you need to take into account not only pain in the right side, but also other manifestations that accompany this pathology. After all, already at the survey stage you can make a preliminary diagnosis and decide on treatment.

    If the discomfort in the right side is caused by a physiological enlargement of the uterus, then such pain is not expressed all the time and is not very intense; it occurs after overeating or a certain load. In this case, the woman’s general condition does not change, and there are no other symptoms. This indicates that such pain is a physiological condition and if it does not bring any other significant symptoms, then there is no need to worry.

    Chronic noncalculous cholecystitis is an inflammation of the gallbladder, which is accompanied by thickening of its wall and irritation of the peritoneum. This is characterized by the appearance of a dull right-sided pain, which is often provoked by fatty foods. This pain appears gradually, it is not very pronounced and is localized under the right rib. Symptoms that may occur include a feeling of bitterness in the mouth, stool problems, nausea or vomiting. Such inflammation may be accompanied by intoxication syndrome – there may be a slight increase in body temperature.

    Severe and sharp pain on the right side can also be caused by hepatic colic. If a pregnant woman had calculous cholecystitis, then the movement of stones can cause just such a sharp pain. This is accompanied by severe anxiety, the woman cannot sit still – such is the severity of the pain. The first signs of the disease may begin with vomiting, which does not bring relief. This condition requires immediate action, since the tone of the uterus may increase and premature labor may begin.

    Aching pain on the right side in pregnant women often develops against the background of a diaphragmatic hernia. Then the pain is persistent and is often accompanied by dyspeptic disorders. Increased pressure in the abdominal cavity causes these symptoms and after childbirth such a hernia may go away on its own.

    Pain in the right side of a stabbing nature can be caused by renal colic. Then it begins in the lumbar region and radiates to the area of ​​the right ovary and genitals. Acute right-sided pyelonephritis is also accompanied by pain in the right side, but this pain is less pronounced and is permanent. With kidney pathology and urolithiasis, there are always disturbances in the urination process. There may be pain or pain along the ureters, as well as frequent urination or a false urge to urinate.

    Pain in the right side in pregnant women can be initiated by acute enteritis. After certain foods, there may be a mild inflammatory process in the intestines, which is accompanied by pain and stool disturbances. Symptoms develop gradually and are always associated with the consumption of certain foods.

    Pain in the lower right side during pregnancy is always alarming in terms of acute surgical pathology. Acute appendicitis is always accompanied by inflammation of the peritoneum. The characteristic symptoms of this disease are that the pain begins in the epigastrium under the sternum, and then it moves down the abdomen to the right. Then another symptom appears – Shchetkin-Blumberg, when the peritoneum in this place is irritated.

    Premature placental abruption begins with sharp pain in the right side, where the placenta detaches and is accompanied by bleeding. The area of ​​the detached placenta allows blood to pass through, disrupting the normal blood circulation of the fetus, which is accompanied by symptoms from the fetus. Then the heartbeat may increase or decrease and hypoxia occurs, which entails serious consequences.

    Thus, many causes of pain in the right side during pregnancy require careful diagnosis with identification of all symptoms and additional research methods.

    Diagnosis of pain in the right side during pregnancy

    Diagnosis of any pain syndrome during pregnancy should exclude conditions that threaten the life of the child and mother. Therefore, all additional tests must be carried out to ensure normal fetal development.

    It is important to find out all the anamnestic data, determining the nature of the pain, its intensity, and its connection with food. It is imperative to find out whether the woman has chronic diseases, such as cholecystitis, enteritis, or urolithiasis. You should also ask about other symptoms, whether they are associated with pain, and whether the woman has taken pain medications. If a woman has had an appendectomy, then this diagnosis can be easily excluded.

    When examining a pregnant woman, you must first examine the child’s reaction to this pain. It is necessary to determine the heartbeat and movements of the fetus, its condition with such symptoms. To exclude pathology of the liver and gallbladder, you need to identify all the symptoms. Positive symptoms of Ortner, Mussi, Murphy, or at least some of them, give reason to suspect an exacerbation of cholecystitis.

    It is necessary to check the Pasternatsky symptom; if it is positive on at least one side, then this is a probable kidney pathology.

    Diagnosis of acute appendicitis in a pregnant woman is a little complicated, since an enlarged uterus can change the position of the appendix. But the characteristic symptom of pain, first in the epigastrium, and then in the right lower abdomen, occurs very often. When examining such a woman, it can be determined that maximum pain occurs when the doctor removes his fingers from the abdomen, and not when he touches. To accurately exclude acute abdominal pathology, additional studies are always necessary.

    The tests that need to be taken should also be carried out for the purpose of differential diagnosis. It is necessary to take a general blood test, a general urinalysis and determine the blood glucose level. Further, special tests are needed that exclude this or that pathology. If appendicitis is suspected, the blood test will show significant leukocytosis with a shift of the formula to the left and accelerated ESR. The same changes are characteristic of cholecystitis. If there is a suspicion of liver pathology, then a biochemical blood test is needed to determine the level of bilirubin, its fractions and cytolytic enzymes.

    If all laboratory parameters are within normal limits, then it is necessary to conduct an instrumental study to exclude or confirm a certain diagnosis. The main method of instrumental diagnosis during pregnancy can be considered ultrasound. This method is not so harmful to the child and can be of great diagnostic value for establishing most diagnoses. According to the results of the ultrasound, we can say that the gallbladder is inflamed – then its wall will thicken and there will be a fuzzy shadow in the cavity. A stone in the gall bladder or ureter can be identified and colic can be confirmed. Acute right-sided pyelonephritis can also be defined as an expansion of the pelvic system.

    If acute appendicitis is suspected, a rectal examination is performed. The benefit of this diagnosis is evidenced by sharp pain in the rectal wall in the projection of the appendix upon palpation. This is a very serious symptom that confirms acute pathology.

    In addition to the condition of the mother, ultrasound allows you to assess the condition of the fetus. Placental pathology and other pregnancy complications can be excluded, which is important for differential diagnosis. If the disease occurs in the third trimester, then in addition to fetal ultrasound, a cardiotocogram is required to determine the child’s condition and the risk of complications. Then it is possible to determine a violation of the heartbeat, increased uterine tone and premature birth, which can be the cause of pain in the right side with the same probability as other pathologies.

    Differential diagnosis of pain in the right side during pregnancy

    Differential diagnosis of pathology that causes pain in the right side during pregnancy is aimed mainly at determining the cause. It is necessary first of all to differentiate an attack of acute appendicitis and right-sided renal colic. These pathologies have a similar manifestation, but with appendicitis there is an increase in temperature and other signs of inflammation, and colic can be accompanied by vomiting and nausea without an increase in temperature.

    It is equally important to differentiate the pathology of internal organs directly from the causes of pregnancy itself. Premature placental abruption has a clinical picture with a similar pain syndrome, especially if the placenta is detached on the right. But at the same time, bloody discharge is often observed, and this can be confirmed using an ultrasound examination – a retroplacental accumulation of blood is determined. This is an urgent situation that requires immediate action, so in a pregnant woman it is first necessary to differentiate this condition from other pathologies.

    Correct diagnosis and cause of the disease is necessary in order to begin treatment on time, before complications arise.

    Treatment of pain in the right side during pregnancy

    Treatment of a pregnant woman sets the main task of eliminating the cause of pain, but first of all it is necessary to reduce the severity of the pain syndrome so that there is no premature birth and other complications. If we are talking about acute surgical pathology, then drug treatment is only part of the preparation for surgery.

    If the cause of acute pain is renal or hepatic colic, then immediate anesthesia is necessary, since the severity of the pain syndrome is very strong.

  • Baralgin is a universal combination remedy that is used to treat colic. The drug contains metamizole, which has an analgesic effect, as well as fenpiverine and pitofenone, which have an antispasmodic effect. Thanks to this composition, there is an analgesic effect, and it also has a good effect on the tone of the uterus. Method of administration: intravenous or intramuscular. The dosage of the drug per dose is from two to five milliliters. Side effects that may occur are skin flushing, fever, chills, increased body temperature, weakness, rapid heartbeat, arterial hypotension, headache, dizziness, insomnia, nausea, constipation, vomiting, local reactions at the injection site. Precautions – use during pregnancy is decided on an individual basis and only under the control of the condition of the woman and the fetus.
  • Diclofenac sodium is a non-steroidal anti-inflammatory drug that relieves pain due to colic and can be used as an alternative remedy in case of contraindications to others. Dosage – 50 mg at a time after meals. Side effects – dyspeptic disorders, dizziness, hepatitis, erosive and ulcerative lesions of the stomach, duodenum, allergic rash (rarely), “aspirin asthma”. Given the strong effect on the gastrointestinal tract, it is advisable to take the drug under the guise of proton pump inhibitors.

    • If pain in the right side, according to accurate ultrasound data, is caused by right-sided pyelonephritis, then it is necessary to use complex treatment, the main element of which is restoration of urine outflow. In pregnant women, pyelonephritis is secondary due to the fact that the uterus compresses the ureters, so a mandatory element of treatment is stenting to restore the outflow of urine. Then you need to prescribe an antibiotic that is suitable for pregnant women. Such approved antibacterial agents include unprotected aminopenicillins and cephalosporins. If we are talking about an exacerbation of chronic cholecystitis, then it is necessary to use an antibiotic in treatment. Antipyretic and antispasmodic medications can be added to complex treatment.

  • Cefpodoxime is a 3rd generation beta-lactam antibiotic, particularly effective in its bactericidal effect on gram-positive and gram-negative flora. The drug has a bactericidal effect on possible anaerobic pathogens of urinary tract infections, so it can also be used for cholecystitis. The dosage of the drug is 200 mg twice a day, for at least ten days. Side effects are possible if they affect the stomach – colitis or dysbacteriosis develops, which is manifested by bloating and stool disturbances. Precautionary measures – do not use the drug if you are allergic to penicillin antibiotics, as well as with congenital enzymopathies.
  • If the phenomenon of abdominal pain is associated with compression of the intestines, then stool disorders and dyspeptic symptoms often occur, which leads to poor nutrition of the woman. Therefore, the use of probiotics in the treatment of such conditions can solve all problems.

    • Lactobacterin is a drug that contains lactobacilli, which form lactic acid and prevent pathogenic bacteria from multiplying. Thanks to this, the drug creates favorable conditions for the development of beneficial intestinal microflora. These properties of the drug contribute to the fact that spasmodic phenomena in the intestines disappear and pain decreases if the cause is physiological changes. The dosage sufficient to restore microflora and intestinal motility is one dose of the drug once a day. Side effects include diarrhea or a feeling of heaviness and fullness in the stomach, which goes away after a while. Precautionary measures – if there are symptoms of food poisoning, then taking the drug should be agreed with a doctor.

    Vitamins can be used by a woman to treat pain and discomfort that is caused by functional bowel spasms. In this case, you should give preference to complex vitamin products with increased amounts of magnesium.

    Physiotherapeutic treatment is possible only if it is not contraindicated for a pregnant woman and will not harm the child. For example, during exacerbation of chronic cholecystitis, thermal procedures cannot be used.

    Surgical treatment of pain in the right side during pregnancy is the main method if a woman has acute appendicitis. In this case, general anesthesia is performed, taking into account minimal harm to the child, and the operation begins. Surgical access depends on the duration of pregnancy and the degree of uterine enlargement. In most cases, a classic approach is performed in the right iliac region and the inflamed appendix is ​​removed by bypassing the uterus.

    If the cause of pain is premature placental abruption, then the woman should be immediately hospitalized in a maternity hospital to determine the need for delivery.

    Alternative treatment for pain in the right side during pregnancy

    Traditional methods of treating such pain are widely used if there is no organic pathology. If a woman has chronic cholecystitis or urolithiasis, agents are used that reduce the formation of stones. If intestinal function is impaired, then agents are also used to improve peristalsis and normalize digestive function.

  • Calamus root tincture with walnuts has excellent detoxifying and antioxidant properties, which reduces the amount of harmful substances and speeds up digestion. This helps not only reduce intestinal soreness, but also neutralizes nausea and heartburn. To prepare a medicinal tincture, you need ten grams of calamus root and the same amount of nut shells, pour half a liter of water, and then after it has infused for twenty minutes, strain and drink. Dosage – a teaspoon should be drunk three times a day, preferably freshly prepared.
  • Viburnum with sugar has a very good effect on the general condition of a woman, improves blood circulation of the placenta and has antioxidant and immunomodulatory properties. To do this, it is enough to take viburnum ground with sugar throughout pregnancy. It is also an additional source of vitamin C.
  • Grape leaves have many useful tannins and, thanks to this, exhibit their antispasmodic properties well. Therefore, for severe spasmodic pain caused by gallbladder pathology, use a tincture. To do this, you need to pour three large grape leaves with liquid fresh honey and leave to infuse for a month. The tincture should be stirred periodically and at the end of the period add a few drops of olive oil. This infusion should be taken in case of pain, a teaspoon at a time; it neutralizes the pain syndrome and does not harm the child.
  • To speed up the removal of kidney stones, it is recommended to take green tea with milk. To do this, boil a liter of milk and add a tablespoon of any green tea leaves. You can drink it hot or cold several times a day.

    • The use of herbs also has a good effect on a spasmodic gallbladder and intestines, improves the flow of bile, and normalizes digestion. For this purpose, various infusions and herbal teas are used.

  • Rosehip infusion cleanses the liver well and normalizes appetite, so this infusion can be used to treat pain caused by liver pathology. To do this, you need to boil the rose hips in water and leave. Before taking, you can add sugar and citric acid.
  • Yarrow is a plant that reduces the inflammatory process in the gallbladder and reduces the tone of the sphincter muscles, so bile drains better. The medicine is used in women with chronic cholecystitis in the form of an infusion. For the best antispasmodic effect, you need to pour 30 grams of yarrow and eucalyptus herbs with cold water and leave for three days. Then, before use, you need to strain the broth and boil it, only after that you can take twenty grams in the morning and evening.
  • You need to take 200 grams of dandelion and plantain herbs, make tea from two liters of water and drink in small sips throughout the day. The course of treatment is four weeks after the onset of nagging pain, then all processes should normalize and the symptoms will subside.

    • Homeopathy can be used for many processes in the intestines and gall bladder, and there is no harm to the child. Homeopathic remedies can be combined in such a way as to act on many processes in the body of a pregnant woman, which expands the possibilities of using this group of medicines.

  • Sanguinaria is a homeopathic remedy that has a composition of organic agents and helps to normalize the liver, gall bladder and pancreas with a slight analgesic effect, which eliminates the severity of functional pain in the left hypochondrium. The method of application is in drops and a dosage of four drops twice a day, half an hour before meals at the same time. The course of treatment is three months. No side effects were identified. Contraindications to use are hypersensitivity to the components of the drug.
  • Bryonia album is a homeopathic remedy that consists of herbal preparations that are more effective in patients with pain that is localized to one side of the abdomen or migrates from one side to the other, causing weakness and asthenia. The method of using the drug is three drops three times a day, under control of the heartbeat; if tachycardia occurs, the dose can be reduced. No side effects were identified. Precautionary measures – do not take if you are allergic to lilies.
  • Bromine is a drug of homeopathic origin from the group of inorganic drugs. Used to treat pain in the right side, which is caused by dysfunction of the gallbladder and has a strong spasmodic nature. The drug is most effective in patients who are nervous a lot and have poor sleep. Directions for use: two homeopathic grains three times a day. Side effects are possible in the form of hyperemia of the skin of the hands and feet, as well as a feeling of heat. Precautionary measures – do not use in combination with sedatives, as there may be additive effects.
  • Carbonia compositum is a homeopathic remedy of natural origin. This remedy is used to treat pain in pregnant women that is caused by chronic pyelonephritis or impaired renal function. It has a diuretic effect and removes toxins. The drug is dosed two grains three times a day. Side effects are not common, but nausea and bloating may occur. Precautions – use of the drug in the acute period of intestinal infection is not recommended.

    • Complications and consequences of pain in the right side during pregnancy

    The consequences of pain in the right side can be very serious, especially when it comes to acute surgical pathology. Complications of acute appendicitis can be in the form of spread of the process to the peritoneum and the development of purulent peritonitis. This is a very serious complication not only for the mother, but also for the child. The consequences of untimely diagnosis of pain syndrome can be very serious, especially when it comes to diseases such as cholecystitis. Then there may be empyema of the gallbladder and the spread of infection with the formation of subhepatic abscesses. The consequence of untimely diagnosis of placental abruption may be a large retroplacental hematoma, which will ultimately lead to the need to remove the uterus.

    Given such complications, it is necessary to diagnose diseases in a timely manner.

    Prevention of pain in the right side during pregnancy

    Prevention of pain in the right side during pregnancy is nonspecific, since this condition is difficult to predict. To avoid complications and exacerbations of chronic diseases before planning a pregnancy, you need to be thoroughly examined and prevent these symptoms. For a normal pregnancy, it is necessary to follow a routine, food should be fresh and healthy. It is necessary to protect the health of a pregnant woman as much as possible to avoid various infections.

    Prognosis of pain in the right side during pregnancy

    The prognosis for a normal pregnancy and the birth of a healthy child is favorable, even if the pain is caused by acute appendicitis, but timely treatment was carried out. Therefore, the main element is the timeliness and adequacy of treatment.

    Pain in the right side during pregnancy can often indicate an inflammatory process in the gallbladder, intestines, or acute appendicitis. Therefore, when such symptoms appear, you must first rule out such serious diseases, especially if there are other symptoms. All conditions can be easily treated and there is no need to worry about the life of the unborn child, because the prognosis is favorable with timely treatment.

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