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What is round ligament pain?

Round ligament pain is a specific type of abdominal pain that almost 10 to 30% women experience during the 2nd trimester of pregnancy. Though it is a normal part of pregnancy, the pain draws concern as it tends to exacerbate with movement such as walking, lifting objects or on changing positions. Round ligament pain may be felt on one or both sides of the abdomen and hips or it may radiate down to the groin.

What are the main causes?

Round ligament is a fibro-muscular connection between the upper end of the uterus and the pubic area. This connection clinically appears as a band of rope present on the lateral sides of the uterus and has a length of about 10 to 12 cm. The basic function of round ligament is to maintain the natural positioning of the uterus during pregnancy. In non-pregnant females, round ligament is pretty flexible but secured in its place; however, during pregnancy, it increases in length and diameter to provide additional support to the uterus. The weight of the growing baby further causes this ligament to stretch, eliciting pain. 

Round ligament pain is not a symptom of any disease. The following factors may trigger the pain:

  • Laughing
  • Coughing
  • Walking
  • Sudden change in position
  • Sneezing
  • Standing quickly 

What are its main signs and symptoms?

Round ligament pain manifests as a sharp, stabbing pain or a dull ache in the groin region or lower abdomen. The pain is reversible and alleviates spontaneously. 

In very few cases, the pain might continue and does not subside, in this case, consultation with a specialist is necessary in order to rule out the cause of the pain.

How is it diagnosed?

Round ligament pain is generally diagnosed through apparent symptoms and the clinical history of the patient. However, the doctor may also conduct a physical examination to rule out any other possible causes of the pain. 

If it’s your first pregnancy, make sure to talk to your doctor to know more about round ligament pain and ways you can deal with it. 

In some cases, to be on the safer side, Doppler ultrasonography may be recommended.

How is it treated?

In most cases, round ligament goes away on its own though every episode leaves the patient with significant discomfort. Here are some ways you can get temporary relief from this pain:

  • Warm compress: Warm compress subsides the pain quickly, giving the much-needed relief. It can be done by both, moist compress and dry compress
  • Adequate rest: Rest is the best treatment for round ligament pain. It helps your body to heal the pain on its own. So, make sure to take adequate rest throughout the day and do not overexert yourself
  • Regular stretching exercise: Few low-intensity exercises like stretching turn out to be very helpful in reducing the pain and discomfort. Bending or flexing the hip joint might also alleviate the related symptoms. However, it is best to avoid prolonged standing and lifting heavyweights
  • Avoid sudden movements: Since round ligament pain is triggered by sudden jerks to the abdominal area, it is recommended to keep a check on your movements during pregnancy. If you feel like sneezing, coughing or laughing, bend or flex your hips to reduce stretching of the ligament
  • Avoid triggers: Triggering factors may vary for every individual. Figuring them out would help to prevent the pain

When to see a doctor?

Call the consultant doctor if you notice any of the following symptoms:

  • If pain persists after taking adequate rest
  • If the duration of pain is more than a few minutes
  • If the pain worsens
  • If pain occurs with bleeding, cramping or change in type and amount of vaginal discharge (Read more: Vaginal discharge during pregnancy)
  • If the pain is associated with fever, chills, nausea or vomiting

(Read more: Abdominal pain during pregnancy)

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References

  1. Sambit Mukhopadhyay, Edward Morris, Sabaratnam Arulkumaran. Algorithms for Obstetrics and Gynaecology . OUP Oxford, 18-Sep-2014; Medical, 336 pages
  2. Chaudhry SR, Chaudhry K. Anatomy, Abdomen and Pelvis, Uterus Round Ligament . [Updated 2018 Dec 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan.
  3. American Pregnancy Association. [Internet]; Round Ligament Pain.
  4. American Pregnancy Association. [Internet]; Cramping During Pregnancy.
  5. Soumya Cicilet. Acute groin pain in pregnancy: a case of round ligament varicocele . BJR Case Rep. 2017; 3(3): 20150517. PMID: 30363175
  6. NSW Health [internet]: New South Wales government. Australia; Common Concerns in Pregnancy
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