Right Lower Quadrant Pain in Pregnancy

Authored by , Reviewed by Dr Colin Tidy | Last edited | Meets Patient’s editorial guidelines

Your right lower quadrant is the bottom right side of your tummy (abdomen) from the tummy button down. There are many causes of right lower quadrant pain in pregnancy. Most are of no concern, but it is important to seek medical help if your pain is severe, doesn't settle, or is associated with other symptoms.

Even if you are pregnant, you can still have tummy pain caused by all the same conditions seen in non-pregnant women. See our separate leaflet called Right Lower Quadrant Pain. The rest of this leaflet looks only at common causes specific to pregnancy. Some examples of rarer causes are provided in Further Reading.

Miscarriage

  • This is very common in the first twelve weeks of pregnancy (first trimetster) - about 1 in 4 recognised pregnancies end in miscarriage.
  • It can happen later in pregnancy (second trimester) but this is less common.
  • Miscarriage usually causes cramping pain, like period pain, over both sides of the lower tummy.
  • It is often accompanied by bleeding, which can range from a small amount of dark blood to larger amounts of bright red blood with clots.

You can find out more in the separate leaflet called Miscarriage and Bleeding in Early Pregnancy.

Constipation

  • Constipation is very common in pregnancy.
  • It gives you crampy lower tummy (lower abdominal) pains.
  • You will open your bowels less often than you usually do and typically you pass hard, pellet-like stools (faeces).

You can read more about this in the separate leaflet called Constipation.

Pelvic ligament pain

  • Typically this starts at around 14 weeks and goes on into late pregnancy.
  • It is due to the growing womb (uterus) pulling on the structures (round ligaments and broad ligament) which hold it in place.
  • It usually causes a stabbing pain down one or both sides of the tummy (abdomen) and sometimes down into the hips and genital area.
  • Pain can be quite marked.

You can read more about this in the separate leaflet called Common Problems in Pregnancy.

Urine infection

  • Urine infection is more common in pregnancy.
  • Usual symptoms are of pain when you pass urine and passing urine more often.
  • You may also get tummy pain and a high temperature (fever) and notice blood in your pee.
  • If you do get pain, it's usually across the lower tummy but can be on one side if you are developing a kidney infection (pyelonephritis).

See the separate leaflet called Urine Infection in Pregnancy.

Ectopic pregnancy

You should always see a doctor urgently if you think you might be pregnant and are experiencing right lower quadrant (RLQ) pain. You could have an ectopic pregnancy.
  • An ectopic pregnancy is a pregnancy that is not in the womb.
  • Pain is often sudden and can be severe, but it can come on over a few days.
  • You may have missed your period but you can still have an ectopic pregnancy even if you think you have had a period.
  • Vaginal bleeding often happens but not always.
  • Occasionally you can get pain over the tip of your shoulder.

See the separate leaflet called Ectopic Pregnancy.

Right lower quadrant pain in later pregnancy

Pelvic girdle pain affects the joint connecting the two bones at the front of your pelvis, called the symphysis pubis. This joint becomes loosened during pregnancy, often as early as 14 weeks into pregnancy. The pain can be severe and is usually felt over the symphysis pubis, but can spread to the RLQ.

Find out more in the separate leaflet called Common Problems in Pregnancy.

In later pregnancy, RLQ pain can be caused by a placental abruption or by going into labour. Placental abruption happens when there is bleeding between the afterbirth (placenta) and the lining of the womb. Labour is too soon (premature labour) if it happens before 37 weeks.

See the separate leaflets called Premature Labour and Pelvic Pain in Women for more information.

Right Lower Quadrant Pain

Causes in Children

Further reading and references

  • Ghali MAE, Kaabia O, Mefteh ZB, et al; Acute appendicitis complicating pregnancy: a 33 case series, diagnosis and management, features, maternal and neonatal outcomes. Pan Afr Med J. 2018 Jul 1630:212. doi: 10.11604/pamj.2018.30.212.14515. eCollection 2018.

  • Sanches LP, Rahal Junior A, Falsarella PM, et al; Caecal appendix lipomatosis in a pregnant patient mimicking acute appendicitis. Einstein (Sao Paulo). 2020 Dec 718:eRC5415. doi: 10.31744/einstein_journal/2020RC5415. eCollection 2020.

  • Gallaher C, Tahmasebi F, Sayasneh A, et al; Spontaneous Heterotopic Pregnancy Associated with Massive Intraperitoneal Haemorrhage and a Normal Heart Rate, Illustrating the Concept of Relative Bradycardia. Case Rep Obstet Gynecol. 2019 Mar 182019:2893149. doi: 10.1155/2019/2893149. eCollection 2019.

  • Kopko J, Stanczak R, Warzecha D, et al; Uterine torsion in the second trimester of pregnancy. Neuro Endocrinol Lett. 2019 Jan39(6):423-426.

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