Womb PAINS
Dear Dr Mitchell,
I’m experiencing pains deep in my womb after not completing my pregnancy duration. I was pregnant for six months and in the seventh month, the baby died. I went to hospital and they helped me to deliver the baby and now I’m experiencing pains on my womb. What could be wrong?
I am truly sorry to learn about the loss of your pregnancy at such an advanced stage. It is very important that you are thoroughly investigated to determine the underlying cause of the intrauterine death of the foetus before becoming pregnant again so that measures can be put in place to reduce the risk of another pregnancy loss.
In some cases the foetus dies because of an underlying abnormality in its make-up. Infection is also a significant cause of an intrauterine death. A bacterial or viral infection may play a role. Toxoplasmosis, rubella, cytomegalovirus infection, herpes simplex II, syphilis, and human immunodeficiency virus infection may also contribute to an intrauterine death. Women who have a chronic medical condition such as diabetes mellitus and hypertension are also at an increased risk for intrauterine death of the foetus. A lupus anticoagulant antibody positive mother or those with Systemic Lupus Erythematosus (SLE) are also at an increased risk of a bad outcome.
All pregnant women should have an initial screening test done for syphilis and HIV but routine testing for herpes simplex II, cytomegalovirus and toxoplasmosis are not usually done unless there is a problem in the pregnancy such as growth restriction in the foetus or an obvious foetal abnormality. A post mortem examination is definitely useful in detecting abnormalities in the foetus and cultures done on the baby can help to determine if there was an underlying infection causing the death of the foetus.
The severe pain that you experience in your abdomen may be due to several factors. A pelvic infection can cause the lining of the uterus and Fallopian tubes to be inflamed and contribute to significant pain.
A bladder infection can also contribute to significant pelvic pain if left untreated. A urine culture should be done and antibiotics commenced if this is suspected. Uterine fibroids or an ovarian cyst can also cause pelvic pain.
You should get a thorough examination to assess the uterus and ovaries. A vaginal examination can also help to detect any infection in the cervix or vagina that can contribute to pelvic infection and pain. A pelvic ultrasound should be done to assess the uterus for fibroids and to rule out an ovarian cyst.
You should also get a Pap smear done to rule out cervical cancer since this can present with severe pelvic pain in advanced cases. In some cases the pain may actually be due to problems in the bowel and not in the uterus so if there is no abnormality detected in the uterus or ovaries investigations should be done to rule out a problem in the bowel.
Consult your doctor who will advise you further. Best wishes.
Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@jamaicaobserver.com; write to All Woman, 40-42 1/2 Beechwood Ave, Kingston 5; or fax to 968-2025. Dr Mitchell cannot provide personal responses.
DISCLAIMER
The contents of this article are for informational purposes only and must not be relied upon as an alternative to medical advice or treatment from your own doctor.
