Cramping And Pregnancy: Lots Can Happen in these 280 Days

If a patient calls and says she has cramping or pain and a positive pregnancy test, we want to see that patient promptly to get a diagnosis of how far pregnant, and then why she is in pain. Early pregnancy tests are so widely available and so accurate, most women today know they are pregnant when hardly a period day has been missed. Due to the fact that women find out they are pregnant so early, it is not uncommon to feel slight cramping in early pregnancy. Cramping or pain with bleeding is a more significant sign of possible miscarriage, but you cannot tell on the amount of bleeding alone. Later in pregnancy the cramping a woman experiences is probably just the on and off contractions called Braxton Hicks contractions and yet they may actually be labor pains. In general women are asked to have a plan as to when to call their physician if they have cramping. Full term is between 259 and 293 days of pregnancy, and the average is 280, in truth the uterus contracts during most of those days, but mostly we cannot notice. It's really only when the cervix opens up that it is an issue as to whether you are having cramps or not. This is now also predicted based on actual measurements of the cervix.

Preterm birth screening ultrasound becoming routine practice in general obstetric prenatal care. Ultrasound can be used to get a measurement of the length of the cervix. If the measurement of the length of your cervix, performed by ultrasound,  in the second trimester of pregnancy is less than 25 mm then it is considered shorter than what is optimal. The studies show that if women are measured, between the weeks of 19 and 24 weeks of pregnancy, and the measurement is under the 25 mm then about 18% of these patients will deliver before 35 weeks.  Your case can be individualized, and we welcome discussion at your next prenatal visit. And the opening of the cervix can happen without cramps, but that is a different issue. When the cramps become noticeable, even when you are getting closer to term some gynos may tell you to rest, to drink fluids and to then call after a couple of hours. It is not real labor unless the cervix is opening up in addition to the cramping. Most gynos will caution to call if you are leaking fluid or bleeding, especially if you are past the first trimester of pregnancy. But most women will report a bit of cramping, and mostly you will  be able to be reassured that it is normal.  


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