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Are cramps in early pregnancy normal?

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Q: I am early pregnant and am having cramps. Is this a sign of a possible miscarriage?

A: Good news! Cramping in early pregnancy is quite common. If you have no bleeding, cramping is unlikely to represent an impending miscarriage or other pregnancy complication. You just have to get through it until it resolves. Associated early pregnancy bleeding would make the situation a threatened miscarriage, although even then many pregnancies proceed normally.

Severe pain, or pain that is on one side only, can be a sign of a tubal pregnancy (ectopic), a dangerous situation in which the pregnancy lodges itself in the fallopian tube and grows there. Ectopics must be treated urgently, since they can rupture the tube and lead to internal bleeding. Unfortunately the pregnancy cannot be saved when it is in the tube—the focus has to be on the mother's health and future fertility. The earlier an ectopic is diagnosed, the more options for treatment are available, including options to save the tube.

Talk to your doctor or midwife, particularly if the cramps become severe, are associated with vaginal bleeding, or are located on one side only. Good luck!

Dr. Marjorie Greenfield

Obstetrics and Gynecology
A board-certified obstetrician-gynecologist and fellow of the American College of Obstetrics and Gynecology, Dr. Marjorie Greenfield has practiced and taught obstetrics and gynecology since 1987, currently as Professor at Case Western Reserve University School of Medicine and MacDonald Women's Hospital of University Hospitals Case Medical Center.

In addition to clinical practice and teaching, Dr. Greenfield writes extensively for the Web. Her latest project is The Working Woman's Pregnancy Book, published in 2008 by Yale University Press.





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