symptom | Pregnancy-related Abdominal Distension and Fullness |
alias | Pregnancy-related Abdominal Distension and Fullness with Pain, Chest Distention during Pregnancy, Fetal Pressure on the Heart, Fetal Qi Disease Ascending and Oppressing |
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bubble_chart Concept Pregnancy heart abdominal distension and fullness refers to the sensation of bloating and fullness in the heart and abdomen during pregnancy, which may even lead to difficulty in breathing and pain in both flanks.
This condition is referred to as "pregnancy heart abdominal distension and fullness pain" in Taiping Shenghui Fang, as "chest distention during pregnancy" in Furen Liangfang, as "fetal qi pressing on the heart" in Zhengzhi Zhunsheng, as "fetal qi disease pressing upward" in Jingyue Quanshu, and as "the child striking the heart" in Shen's Nyuke Jiyao.
Both pregnancy heart abdominal distension and fullness and fetal water primarily manifest as chest and abdominal distension and fullness, which can lead to shortness of breath in severe cases. However, pregnancy heart abdominal distension and fullness is caused by the counterflow of qi rushing up to the heart and chest, while fetal water heart abdominal distension and fullness is caused by the accumulation of water in the womb. The former is a disease of qi, while the latter is a disease of water; the causes of the diseases are different, and so are the treatments.
bubble_chart Pattern Analysis
- Fetal Heat︰During pregnancy, there is chest and diaphragm stuffiness, distension, and fullness, shortness of breath, distending pain in both flanks, internal heat and dry mouth, restlessness and insomnia, dark urine, a hard tongue texture, yellow and greasy coating, and a surging and rapid pulse. This is mostly due to a constitution with inherent heat, where the blood gathers in the uterus to nourish the fetus, intensifying the heat, leading to fetal heat qi counterflow that ascends to the chest and heart, resulting in distension, stuffiness, and fullness, labored breathing, and distending pain in both flanks. The diagnostic characteristics are: a robust constitution, a surging and rapid pulse, along with signs of internal heat such as dry mouth, restlessness, insomnia, dark urine, a red tongue with yellow coating, etc. Treatment should focus on clearing heat and regulating qi to calm the fetus. The recommended formula is Perilla Leaf Decoction with the addition of Skullcap Root and Gardenia. If the distension and fullness have subsided, follow-up treatment should focus on nourishing yin and blood while clearing heat. The recommended formula is Donkey-hide Gelatin Blood-Nourishing Decoction with the addition of Chinese Wolfberry Root-bark.
- Liver Qi Depression︰During the seventh or eighth month of pregnancy, there is distension and fullness in the chest and diaphragm, distending pain in both flanks, difficulty in breathing, a sensation of qi obstruction and stuffiness, dysphoria, irritability, and frequent sighing. The tongue coating is thin and yellow, and the pulse is wiry and slippery. This condition is often caused by habitual blood deficiency, leading to inadequate nourishment of the liver. The lower body is depleted due to pregnancy, while qi floats upward. Additionally, depression and anger damage the liver, causing liver qi stagnation and failure to flow smoothly. The qi counterflows and rushes into the chest and heart, resulting in abdominal distension and fullness. The clinical features include chest tightness, hypochondriac pain, restlessness, irritability, frequent sighing, a wiry pulse, and a wiry and surging pulse at the left guan position. Treatment should focus on regulating qi and relieving stagnation, using Danzhi Xiaoyao Powder with the addition of Green Calyx Plum and Aquilaria powder. Subsequently, nourishing qi and cultivating yin is recommended, using Donkey-hide Gelatin Nourishing Blood Decoction with the addition of Chinese Angelica and Peony Root.
- Spleen Deficiency with Qi Stagnation︰In the late stage of pregnancy (third trimester), there is abdominal distension and fullness, difficulty breathing, or heaviness of the head with vertigo, fatigue and a desire to lie down, lack of strength in the limbs, poor appetite, a thin white tongue coating, and a weak wiry pulse. This is often caused by inherent spleen and stomach deficiency, and as the fetus grows in the late stage of pregnancy (third trimester), it obstructs the movement of qi, leading to abdominal distension and fullness. The clinical features include heaviness of the head with vertigo, fatigue and a desire to lie down, lack of strength in the limbs, poor appetite, a pale tongue texture, and a weak slippery pulse. The treatment should focus on strengthening the spleen and regulating qi, using Perilla Leaf Decoction with the addition of Villous Amomum Fruit and Officinal Magnolia Flower.
The symptom of abdominal distension and fullness during pregnancy is generally caused by the upward counterflow of qi impacting the chest and heart. It is mostly associated with fetal heat and liver depression, and occasionally with spleen deficiency and qi stagnation.
Zhangshi Yitong.The chapter on women's diseases states: "Most cases of fetal qi disease with upward counterflow are due to excessive fire. It is urgent to use herbs such as Scutellaria, Atractylodes, and Cyperus, and one must not take Great Cold (24th solar term) medicines, as this may lead to other complications." This is the key to treating the symptoms with medication. Once the symptoms are alleviated, it is necessary to nourish the blood and yin to strengthen the root.
bubble_chart Documentation
- Taiping Shenghui Fang."Treatments for Heart and Abdominal Distension and Fullness During Pregnancy": "The heart and abdominal distension and fullness during pregnancy are caused by the accumulation of cold in the abdomen, leading to the retention of fluids. The condition is aggravated by exposure to cold and the consumption of cold drinks, which interact with the body's energy, causing heart and abdominal distension and fullness."
- 《Shen's Nyuke Jiyao.Chest Distention During Pregnancy》: "In the ninth month of pregnancy, due to sudden physical exertion, abdominal pain was felt, and the fetus gradually rose to the chest (heart and abdomen—editor's note), causing blockage of energy and sudden violent screaming and biting. Several people had to hold her down to calm her. The condition is called 'fetal impact on the heart,' which is the most severe form of chest distention during pregnancy. Use Inula and Hematite Decoction without ginseng and jujube."