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Ectopic pregnancy
An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, typically in one of the fallopian tubes. It usually causes symptoms at about six or seven weeks after fertilization, but symptoms may occur as early as four weeks, before you even know you're pregnant.

If left untreated, an ectopic pregnancy can rupture and be life threatening. Call your practitioner immediately if you have any of the following symptoms: abdominal or pelvic pain or tenderness, vaginal spotting or bleeding (can be red or brown, copious or scant, continuous or intermittent), pain that gets worse during physical activity or while moving your bowels or coughing, or pain in the tip of your shoulder.

If you're bleeding heavily or having signs of shock (such as a racing pulse, dizziness, fainting, or pale, clammy skin), call 911.

Miscarriage
Miscarriage is the loss of a pregnancy in the first 20 weeks. Vaginal spotting or bleeding is generally the first symptom, followed by abdominal pain a few hours to a few days later.

The bleeding may be light or heavy. The pain may feel crampy or persistent, mild or sharp, and may feel more like low Back pain or pelvic pressure.

Call your practitioner if you have signs of a miscarriage. If you have severe pain or heavy bleeding, you need to be seen immediately.

Preterm labor
You're in preterm labor (also known as premature labor) if you start to have contractions that efface or dilate your cervix before 37 weeks of pregnancy.

Call your doctor or midwife right away if you're having any of the following symptoms in your second or third trimester (before 37 weeks):

• An increase in vaginal discharge or a change in the type of discharge (if it becomes watery, mucus-like, or bloody --- even if it's just pink or tinged with blood)

• Vaginal spotting or bleeding

• Abdominal pain, menstrual-like cramping, or more than four contractions in one hour (even if they don't hurt)

• An increase in pressure in the pelvic area

• Low back pain, especially if you didn't previously have back pain.

Placental abruption
Placental abruption is a serious condition in which your placenta separates from your uterus, partially or completely, before your baby's born.

There's wide variation in symptoms. A placental abruption can sometimes cause sudden and obvious bleeding, but in other cases there may not be any noticeable bleeding at first, or you might have only light bleeding or spotting. Or you might see bloody fluid if your water breaks.

You might have uterine tenderness, back pain, or frequent contractions, or the uterus might contract and stay hard --- like a cramp or contraction that doesn't go away. You might also notice a decrease in your baby's activity. Immediate medical attention is a must.

Preeclampsia
Preeclampsia is a complex disorder of pregnancy that causes changes in your blood vessels and can affect a number of organs, including your liver, kidneys, brain, and the placenta. You're diagnosed with preeclampsia if you have high blood pressure and protein in your urine after 20 weeks of pregnancy.

Symptoms may include swelling in your face or puffiness around your eyes, more than slight swelling in your hands, and excessive or sudden swelling of your feet or ankles. (This water retention can lead to a rapid weight gain.)

With severe preeclampsia, you may have intense pain or tenderness in the upper abdomen, a severe headache, visual disturbances (such as blurred vision or seeing spots), or nausea and vomiting. If you have symptoms ofpreeclamsia call your doctor or midwife immediately.

Urinary tract infections
Being pregnant makes you more susceptible to urinary tract infection of all kinds, including kidney infections.

Symptoms of a bladder infection may include pain, discomfort, or burning when urinating; pelvic discomfort or lower abdominal pain (often just above the pubic bone); a frequent or uncontrollable urge to pee, even when there's very little urine in the bladder; and cloudy,foul smelling, or bloody urine. Call your caregiver if you have any of these symptoms because an untreated bladder infection can lead to a kidney infection and premature labor.

Signs that the infection has spread to your kidneys --- and that you need medical attention immediately --- include a high fever, often with shaking, chills, or sweats; pain in your lower back or in your side just under your ribs, on one or both sides (and possibly in your abdomen as well); nausea and vomiting; and possibly pus or blood in your urine.

Other causes
Many other conditions can cause abdominal pain, whether you're pregnant or not. Some of the most common causes of abdominal pain that your practitioner will consider are a stomach virus, food poisoning, appendicitis, kidney stones, hepatitis, gallbladder disease, pancreatitis, and bowel obstruction.

Both gallbladder disease and pancreatitis are often a result of gallstones, which are more common during pregnancy. The pressure of the growing uterus on previously scarred intestinal tissue may cause bowel obstruction. It's most likely to occur in the third trimester.

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Q: What can cause lower abdominal swelling tenderness and numbness during pregnancy?
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