Falls occur commonly in pregnant women, due to changes in the center of gravity and the relaxation of joints and soft tissue that occur in pregnancy. The constant shift of body mechanics plus inner ear changes cause around 27 percent of women to tumble at least once during pregnancy, and 10 percent fall more than once, lead author Kari Dunning of the University of Cincinnati reported in the September 2010 “Maternal Child Health Journal." Falls account for 17 to 29 percent of trauma in pregnancy, a study by Grace Lemasters of the University of Cincinnati states. Abdominal pain after a fall can have serious consequences and need medical evaluation.
In the first trimester of pregnancy, the uterus is still contained within the pelvis, making injury to the fetus less likely. Falls later in pregnancy have a higher potential of injury to the uterus or fetus. Blunt trauma can injure other parts of the abdomen as well as the uterus. Laceration of the liver or spleen can cause abdominal pain at any stage of pregnancy.
Abdominal pain can be crampy or steady. Crampy pain may indicate preterm labor, and also is associated with periodic tightening of the abdomen. Steady, severe pain, especially if associated with a rock hard abdomen, may indicate internal bleeding and placental abruption, detachment of the placenta from the uterine wall.
Any pregnant woman who has abdominal pain after a fall should see her medical practitioner for evaluation. Fetal monitoring can diagnose the presence of uterine contractions and fetal well-being, while fetal ultrasound can check the attachment of the placenta. As many as 50 percent of all women with blunt abdominal trauma will have contractions, which usually subside with rest and fluids. An abnormal fetal tracing on the fetal monitor indicates potential abruption.
Fetal distress occurs early in most cases of placental abruption, since blood flow to the fetus is interrupted. Around 40 to 50 percent of infants who survive have complications ranging from mild to severe. Placental abruption can also cause fetal death or maternal death. Preterm labor from blunt trauma occurs in 5 to 15 percent of cases, mostly in conjunction with placental abruption, OBGYN Morning Rounds reports. Preterm delivery, which occurs in only 1 to 2.5 percent of these cases, can cause a host of complications for the infant ranging from respiratory difficulties to bleeding inside the brain.
Treatment of abdominal pain after a fall in pregnancy depends on the cause. Preterm labor may subside with rest and hydration. Small abruptions may seal over and not require intervention. Placental abruption that causes significant detachments requires immediate delivery of the fetus and may require hysterectomy if bleeding doesn’t stop after delivery, MedlinePlus warns.