Group 1features Suggesting Hospital Referral
There are very clear signs of definite surgical pathology with a large number of typical features of disease, for example classic appendicitis. In these patients the management plan is straightforward and little further investigation is needed in the emergency department. These patients should, therefore, be referred to the appropriate inpatient team .
Box 2 Common Presentations Of Primary Survey Positive Patients
Heavy vaginal bleeding
Complications of labour
Shock can be attributable to either hypovolaemia or sepsis. En route to hospital obtain intravenous access and draw blood for cross matching. Remember to complete the patient details on the blood specimen tube. No intervention should delay transfer to definitive medical care. Intravenous fluid resuscitation in abdominal haemorrhage should be based on the principle of hypotensive resuscitation, aiming to give enough fluid to maintain a radial pulse.
When To Call Your Doctor
When should you be concerned about cramps during pregnancy? To be on the safe side, always contact your practitioner if youre worried about pregnancy pains including cramping.
Be sure to get in touch with your practitioner right away if youre experiencing:
- Severe lower abdominal pain in the center or on one or both sides that doesnt subside
- A sudden increase in thirst, accompanied by a decrease in urination, or no urination for a full day
- Severe headache that won’t go away, vision changes, sudden swelling and/or unexplained weight gain
- Fever or chills
- Heavy bleeding, or bleeding with cramps or severe pain in the lower abdomen
- Bloody diarrhea
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Symptoms Of Ovulation Pain
The symptoms of ovulation pain can include:
- pain in the lower abdomen, just inside the hip bone
- pain typically occurring about two weeks before the menstrual period is due
- pain felt on the right or left side, depending on which ovary is releasing an egg
- pain that may switch from one side to the other from one cycle to the next, or remain on one side for a few cycles
- a pain sensation that can vary between individuals for example, it could feel like uncomfortable pressure, twinges, sharp pains or cramps.
- pain that lasts any length of time from minutes to 48 hours.
Back Pain After Period
Did you asked yourself why do your back hurt during or after your period? Well, these pains are sometimes normal and are caused by the uterine contractions which radiate to the pelvic area.
When the body contracts itself in the attempt of getting rid of the uterine mucosa during menstruation, there may be a pressure put on the blood vessels on that area, which leads to a restriction or loss of oxygen supply of the close by muscles. This leads to these pains that may sometimes last for a few days after your periods ends.
You shouldn`t worry about this being a pregnancy sign as long as you don`t experience other symptoms.
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Causes For Cramps At Other Points In Your Cycle
Sometimes in our cycles, we experience random or irregular lower stomach pain and cramps, which can be confusing and often cause us to worry.
It is common to experience cramps during your menstrual period, as your uterus is contracting to expel its lining, which triggers uterine muscle contractions and causes us to feel cramps. Women with higher levels of prostaglandins, which are substances involved in triggering pain, will experience more severe period cramps than other women.
Menstrual cramps can be more common for people who started puberty before the age of eleven, those who smoke, and anyone with a family history of severe period cramps. If you tend to bleed heavily during your cycle, then it is more likely that your cramps will be more severe.
When you’re trying to conceive, you might experience a new kind of cramp just before your period starts, which could signify the implantation of a fertilized egg in your uterus. Ovulation cramping is very normal if you’re trying to conceive. If you’re experiencing small cramps for between one and five minutes at a time mid-cycle, this might be what is to blame.
Symptoms Of Cramps After Period
It is good to be able to differentiate our normal period pain from abnormal cramps, so these symptoms might be able to point you in the right direction for what to look out for.
Most of the time cramping will feel like aching and lower abdomen or pelvic pain, which can range from severe cramping and pain to just a little bit of pressure.
You might also be experiencing lower back pain, or hip and leg pain as well as abdominal pain, and feelings of fatigue and weakness.
Some women experience headaches and nausea, and even vomiting and diarrhea as symptoms that happen alongside cramps, and this can point to something that you should seek medical advice about.
If your cramps are caused by implantation of an egg, then nausea and tender breasts are symptoms of early pregnancy, so this could also be happening alongside your cramps and pain.
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When To See The Doctor For Menstrual Cramps Without A Period
Whether to see your doctor for your menstrual cramps depends on the additional symptoms you may be experiencing. Although there are many natural reasons why you might have cramps without a period, enough causes for concern exist that you may wish to see a doctor anyway.
Consider the following before making your decision:
- How painful your cramps are
- How long your pain lasts
- Whether you have other symptoms in addition to cramps
- Where you are in your monthly menstrual cycle
Breast Pain After Your Period
If you have breast pain after your period, then it may not be related to your period. Instead, it may be noncyclic pain caused by something else. It may affect one or both breasts. Some possible explanations for breast pain after your period include pregnancy, trauma to the breast, a poorly fitting bra, mastitis, and fibrocystic breast changes. Costochondritis and back, shoulder, or neck sprains may also feel like breast pain. Taking certain medication such as antidepressants and oral contraceptives can also cause breast pain after your period. Having surgery on your breast and the resulting formation of scar tissue can also result in breast pain.
Most breast cancers dont cause pain. But if you experience breast pain after your period that doesnt get better, you should consult your health care provider immediately, particularly if you have any of the following signs and symptoms.
- A lump in your breast
- Any clear or bloody discharge from your nipple
- Symptoms of a breast infection including pus, fever, redness, or tenderness
- Pain or lump in your breast without any cause or that doesnt get better
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Causes Of Menstrual Cramps Without A Period
There are many reasons why you might have menstrual cramps without your period, ranging from normal and natural to serious medical conditions. If youre only experiencing sudden or unexpected cramps, it may not be easy to tell one from the other.
Here are just a few of the reasons you might have non-period cramps:
You may be ovulating. This is the simplest and most common reason for cramps outside your period. Ovulation happens naturally within 10 to 14 days of your period when your ovaries release an unfertilized egg as part of your menstrual cycle. This doesnt always cause pain, but many women report dull or sharp pains around their lower abdomen during ovulation.
Another common reason you may have menstrual cramps without a period is pregnancy. Cramping can and often does occur when a fertilized embryo implants itself into your uterine lining. Be on the lookout for other pregnancy-related symptoms, especially spotting, breast tenderness, and nausea .
Given the wide variety of possible causes, its a good idea to have your symptoms checked out by a health professional if youre experiencing unusual menstrual cramps.
What Should You Do If You Have Implantation Cramps
If you have cramping that isn’t followed by your period, it may be related to implantation. Dr. Hou notes it might be too early take a home pregnancy test, since the hormone hCG needs to reach high enough levels for detection. Home pregnancy tests are most accurate if taken after a missed period.
Visit a doctor if cramps are sharp and radiate throughout your pelvis and abdomen. This may signal ectopic pregnancy, which means the embryo implanted outside of the uterus. Ectopic pregnancy may also involve vaginal bleeding, shoulder pain, dizziness, and weakness.
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How To Tell The Difference Between Menstrual Cramping And Implantation Cramping
Dr. Linda Burke-Galloway, MD says, “The character and intensity of pain in “period cramps” and “pregnancy cramps” are very similar, but the timing of pain might provide clues.” Period cramps, otherwise known as primary dysmenorrhea, occur 24-48 hours before your period and go away once menstruation starts. They can range from mild to severe, depending on the level of prostaglandinsa hormone-like substance that triggers uterine muscle contractions. In contrast, implantation cramping occurs 2-7 days before your period and starts off very mild. You will only feel it intermittently in your lower stomach or lower back.
An Inflammatory Bowel Disease
What it is: You get long-term swelling and irritation in different parts of your digestive tract. It happens when something goes haywire in your immune system. It isnât the same as irritable bowel syndrome . Crohn’s can affect any part of your digestive tract . Ulcerative colitis involves only the large intestine .
What the cramps feel like: It depends on the type of IBD you have. With Crohn’s, youâll feel cramps and pain in the right lower or middle parts of your belly. They can be mild to severe. If you have ulcerative colitis, the cramps will be on the lower left side of your stomach.
Other symptoms: Which ones you have depend on the specific type of IBD. They include:
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Brown Discharge From The Cervix
Sometimes, brown discharge doesnt come from the uterus, but from the cervix. In this case, the cervix presents inflammatory symptoms: the mucous membranes, being very fragile, can bleed as soon as they are used.
The doctor may perform a vaginal discharge examination to rule out any infection, and/or pelvic ultrasound as soon as there is any doubt.
Tummy Twinges Pinching And Pulling
Some women experience feelings inside their stomachs in the early stages of pregnancy that replicate the sensation of their muscles being pulled and stretched. Sometimes referred to as abdominal twinges, these tingles are nothing to worry about.
Layla Rumble, midwife at The Portland Hospital, which is part of HCA Healthcare UK, said, Abdominal twinges and mild pains are very common during pregnancy and usually nothing to worry about. Twinges and abdominal pain is usually caused by constipation, ligament pain, or trapped wind all of which are a normal part of pregnancy.
Twinges, and pains can be alleviated by regular light exercise, eating smaller, frequent meals, having plenty of fibre-rich foods such as fruit and vegetables, and drinking plenty of water to help empty your bladder regularly.
If you find that you experience intense and ongoing pains, or pain accompanied by bleeding, it is important to seek medical advice from your midwife or GP to rule out anything serious.
What else could it be?If youve been heavily exercising or straining your muscles, you could be experiencing some tension from that, especially if youve focused on ab workouts. A tight stomach can also be due to other factors such as digestive issues, stress or hormonal changes, and doesnt necessarily mean youre pregnant.
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What Should I Do If I Experience Bleeding During Pregnancy
If you experience bleeding, it is wise to have this checked out. If you have been seen in the Early Pregnancy Assessment Unit during your pregnancy, you may contact us directly, up to 15 weeks + 6 days of pregnancy. Your GP or midwife can also help you.
If you have been seen in the EPAU and you then experience more bleeding contact the EPAU. Depending on how much bleeding and for how long the nursing staff will decide if you need to be seen again. A rescan is not always necessary. Sometimes the nurse will advise that you monitor this bleeding at home. A rescan will only be performed if bleeding heavy with clots. If there is a significant change in your symptoms then the nurse will make an appointment to come to EPAU and be either rescanned or to be assessed by the doctor. If bleeding unmanageable then the nurse may advise to be assessed on ward 30 or the Emergency department depending on your symptoms.
Do All Women Get Early Symptoms Of Pregnancy
Every woman is different. So are their experiences of pregnancy. Not every woman has the same symptoms or even the same symptoms from one pregnancy to the next.
What follows is a description of some of the most common early symptoms of pregnancy. You should know that these symptoms may be caused by other things besides being pregnant. So the fact that you notice some of these symptoms does not necessarily mean you are pregnant. The only way to tell for sure is with a pregnancy test.
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Headaches In First Weeks Of Pregnancy
The basic triggers of this early sign of pregnancy are dehydration and stress on the body, according to Dr. Diane Christopher, M.D. The hormone progesterone can cause an increase in blood flow that may in turn stress your body.
- Adjusting to the new pregnancy, in itself, can be a challenge to the body. The resultant stress is said to be the cause of headaches.
- Headaches are more common within the first 12 weeks of a pregnancy.
Other than hormonal changes, the fatigue that has been discussed above can also be a source of migraines and headaches.
Occasional headaches may persist later in your term. They are often caused by increased hunger as the baby puts a stain on the body for nutrients. Other causes include emotional and physical stress, sinus congestion etc.
If the headaches persist longer than four hours, see a doctor especially if they are accompanied by other experiences such as puffy face, poor vision or blurred vision, weight gain, etc. Women who usually have migraines are more likely to get headaches during pregnancy.
Try to relax to relieve tension headaches. Spend some time in a dark, quiet room to relieve tension headaches. If they persist, see a doctor.