bubble_chart Concept

Abdominal pain during pregnancy refers to pain in the lower abdomen experienced by pregnant women. If not properly treated, it can often lead to "threatened abortion," or even bleeding and "late abortion."

This condition, Jingui Yaolue refers to as "abdominal pain during pregnancy," Bencao Gangmu calls it "fetal pain," and Zhangshi Yitong terms it "painful fetus." The abdominal pain that occurs during pregnancy was classified by ancient people into lower abdominal pain, heart abdominal pain, flank abdominal pain, and chest abdominal pain, among others. Yizong Jinjian · The Essential Formulas for Women's Heart Methods states: "Abdominal pain in pregnant women is called abdominal pain during pregnancy. It is necessary to examine the pain: if it is located above the heart and abdomen, it is mostly caused by food stagnation; if it is located below the waist and abdomen, it is mostly caused by fetal qi disease and restlessness." This condition clearly refers to the latter. Other causes of abdominal pain, such as diarrhea, dysentery, or masses, or abdominal pain accompanied by vaginal bleeding, are not within the scope of this discussion.

bubble_chart Pattern Analysis

1. Deficiency-Cold︰Pregnant for several months, with aversion to cold and cold limbs, lower abdominal cold pain that is alleviated by warmth, abdominal distension and fullness, poor appetite, pale tongue texture with thin white and slippery coating, and wiry or thin and weak pulse. The cold originates internally, often due to constitutional yang deficiency. After pregnancy, the fetus is connected to the kidneys, leading to further deficiency of kidney yang. Yang deficiency generates internal cold, and cold congeals to cause abdominal pain during pregnancy, resulting in abdominal pain. Treatment should focus on warming the uterus and dissipating cold, as well as unblocking obstruction and relieving pain. The recommended formula is Mugwort and Cyperus Uterus-Warming Pill.
2. Blood Deficiency︰Five or six months into pregnancy, there is a dull pain in the lower abdomen that eases with pressure. Symptoms include dizziness, blurred vision, severe palpitations, dry mouth without a strong desire to drink, a pale yellow complexion, a pale red tongue with thin white coating, and a fine, wiry, and slippery pulse. This is due to insufficient blood leading to poor qi circulation, often presenting signs of blood deficiency and malnutrition (such as a pale yellow complexion, dizziness, blurred vision, severe palpitations, a pale red tongue, and a fine pulse).
3. Qi Deficiency︰Pregnancy for several months, lower abdominal pain with a bearing-down sensation, intermittent, severe cases occurring dozens of times a day. Flusteredness, shortness of breath, intolerance to exertion, abdominal pain triggered by mild labor. Tongue texture pale, pulse slippery and weak. Due to qi deficiency leading to poor blood circulation. The key points of differentiation are: in blood deficiency, abdominal pain is mild and lingering; in qi deficiency, abdominal pain has a bearing-down sensation. Clinically, it is often accompanied by symptoms of middle qi insufficiency (flusteredness, shortness of breath, intolerance to exertion, pale tongue, slippery and weak pulse). For blood deficiency, treatment should focus on nourishing blood to stop pain, using Donkey-hide Gelatin and Artemisia Decoction; for qi deficiency, treatment should focus on tonifying qi to relieve pain, using modified Astragalus Decoction. If blood deficiency is accompanied by dampness, presenting symptoms such as water-dampness overflow (edema under the eyes and lower legs) and spleen failing to transform (thirst without desire to drink, scanty urine, loose stools, white greasy tongue coating) and other clinical manifestations of spleen deficiency with damp retention, the treatment should focus on nourishing blood and draining dampness to relieve pain, using Angelica and Peony Powder.
4. External Contractionwind-cold︰pregnancy lower abdomen cold pain, aversion to cold with fever, headache body ache, bland taste in mouth poor appetite, tongue texture normal, thin white coating, pulse slippery and floating or floating and tight. Cold invades from the exterior, lodging in the uterus with appendages, causing obstruction of the uterine collaterals, hence sudden onset of pain. The key points of pattern identification are: deficiency-cold abdominal pain, presenting with lower abdomen cold pain relieved by warmth, cold body and limbs, abdominal distension and fullness poor appetite, white slippery tongue coating, etc.; wind-cold abdominal pain, must present with fever and chills, headache body ache, floating pulse and signs of cold invading the uterine vessels. For treatment, it is appropriate to dispel wind and release the exterior, dissipate cold to relieve pain, using Cinnamon Twig Decoction with added Mugwort, cultivated purple perilla stem, and Fistular Onion Stalk.
5. Qi Stagnation︰During pregnancy for several months, there is lower abdominal distension and fullness with pain, chest tightness, hypochondriac distension or pain, irritability, frequent belching, poor appetite, thin white tongue coating, and wiry-slippery pulse. This belongs to the "excess pattern." The liver is the Sea of Blood. After conception, blood gathers to nourish the fetus, leading to liver blood deficiency and susceptibility to liver qi stagnation. Liver depression causes qi stagnation, which in turn impedes blood circulation, obstructing the uterine vessels and resulting in abdominal pain. The key diagnostic points are: lower abdominal distension and fullness with pain, which can be distinguished from the cold pain of cold congelation, the bearing-down pain of qi deficiency, and the lingering pain of blood deficiency. The clinical manifestations must include abdominal distension and fullness, hypochondriac pain, irritability, frequent belching, wiry pulse, and other signs of qi depression with slight relief. Treatment should focus on nourishing blood and regulating the liver, regulating qi and relieving pain, using Peripatetic Powder with Lindera and Cyperus.

The causes of abdominal pain during pregnancy are generally due to poor circulation of qi and blood, leading to blockage of the uterine vessels. The main reasons for the blockage of the uterine vessels are often congealing cold and qi stagnation. If the abdominal pain is severe and accompanied by profuse sweating, immediate emergency treatment should be administered to avoid delaying the condition.

bubble_chart Documentation

1. 《Synopsis of the Golden Chamber．Pulse Patterns and Treatment of Women's Diseases during Pregnancy》: "During the sixth or seventh month of pregnancy, if the pulse is wiry and there is fever, the fetus becomes more distended, and there is abdominal pain with a preference for cold, the lower abdomen feels as if fanned. This is because the uterus is open. It should be treated with Aconite Decoction to warm the viscera."
2. Nyuke Zhengzhi Zhunsheng ．Prenatal Section: "During pregnancy, if there is pain in the lower abdomen and the fetus is slightly unsettled, with qi attacking the sides or sometimes rebelling upwards, and difficulty in urination, use Minor Bupleurum Decoction with green tangerine peel and gardenia to clear liver heat and cure."
3. Fuke Yuchi ．Prenatal: "If abdominal pain is frequently experienced from the beginning of pregnancy, this is due to blood heat and is called painful fetus. It is not easy to cure immediately, only suitable to take cooling blood medicine to slightly alleviate it, suitable for Gardenia and Scutellaria Decoction."
4. Xiezheng Lun ．Treatment of Blood Stasis Syndromes: "Pregnant women with slight abdominal pain can still be divided into two aspects: water and blood. In the water aspect, if the bladder's qi cannot transform water, then the uterus becomes distended and water cannot be discharged, leading to symptoms such as scanty urination, distension, and panting. If it is determined to be heat accumulation not moving, Redness-Removing Powder with gardenia and Stephania Tetrandra can be used to clear it; if it is determined to be cold congealing and yang qi not transforming, Five Ingredients with Poria Powder is the main treatment, taking advantage of its diuretic effect, then the slight abdominal pain will naturally stop, Tangerine Seed Pill with Poria can also treat it. In the blood aspect, the uterus is governed by the liver and kidney, if liver yang does not reach the uterus, then the uterine blood will congeal and stagnate causing pain, Four Ingredients Decoction with Mugwort, Cyperus, Donkey-hide Gelatin, and fennel fruit. If kidney yang does not reach the uterine chamber, then there will be cold pain in the fetus, extending up to the waist and spine, Four Ingredients Decoction with Eucommia Bark, Psoralea, Tai Wu, and Mugwort, this is called abdominal pain during pregnancy. It is said that the yin blood and yang qi in the uterus are blocked. In severe cases, use Kidney Qi Pill , in mild cases, use Colla Corii Asini Four Ingredients Decoction ."
5. Fuqingzhu Gynecology ．Pregnancy: "During pregnancy, if there is pain in the lower abdomen and threatened abortion, as if there is a sensation of falling, people only know that the belt vessel is weak, but who knows that it is due to the deficiency of the spleen and stomach!"