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Round ligament pain in pregnancy

Round ligament pain overview

Abdominal pain of various types is common during pregnancy. One of the common causes is as a result of round ligament pain. Round ligament pain is due to normal changes that take place as your body is transformed by pregnancy. There are other, abnormal, treatable causes of pain that your doctor or midwife may want to check. Therefore, any new or significant pain should be reported to your doctor or midwife.

Round ligament pain causes

Round ligament pain refers to a type of pelvic pain caused by stretching of the round ligaments and movement is the main trigger for this condition. It occurs more commonly on the right side of the pelvis.

  • Your uterus is normally the size of a pear. Thick ligaments, one of which is called the round ligament, hold your uterus in suspension within your abdomen. As the uterus grows in size and weight, these ligaments become very long and thin, stressing and tensing like rubber bands.
  • The ligaments pull and tug on nearby nerve fibres and sensitive structures, causing pain. The severity of pain can worry you. Although round ligament pain is uncomfortable, it is also very normal.
  • A ligament spasm, an involuntary contraction or cramp, usually triggers a sharp pain. These spasms are found more frequently on the right side than the left because of the normal tendency of the uterus to turn to the right.
  • You might wake up at night with pain after having suddenly rolled over in your sleep.
  • The pain may also be brought on by exercise, even walking.

Round ligament pain symptoms

Pain from stretching uterine ligaments can be severe and can be confused with causes outside your pregnancy. Pregnant women may feel acute abdominal pain when the cause is something more serious, such as the following:

  • Appendicitis - an inflammation of the appendix located in your right lower abdomen. You initially have poor appetite, nausea, vomiting, fever and, as the inflammation progresses, worsening pain. As you move further along in your pregnancy, the pain from appendicitis may be felt in the upper abdomen instead of the lower abdomen because of your growing uterus.
  • Pain in ovaries or cysts. The ovary located in this area may twist, or a cyst may rupture, causing sudden severe abdominal pain.
  • Abnormal growths in the abdominal area.
  • Cramps because of slow digestion caused by pregnancy. These occur in the ascending colon and caecum, located in the right lower part of your abdomen.


When to seek medical care

Describe your pain, and any other symptoms, to your GP or midwife, who will assess whether to send you to a hospital’s accident and emergency department or your labour ward. You can always contact the labour ward direct for advice by calling the number in your personally held pregnancy notes or using NHS 111 in England, NHS 24 in Scotland and NHS Direct in Wales. Do not hesitate to seek urgent help if any of the following symptoms occur.

  • Fever
  • Chills
  • Pain on urination
  • Difficulty walking
  • Persistent pain or new pain (round ligament pain tends to be short-lived)
  • Pain and bleeding
  • Severe or increasing pain
  • If you simply want reassurance.
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