34 weeks pregnant with chronic stomach ache nausea and severe headache I have a cerclage also it feels like is ripping through my cervix Previous preterm labor what do you think is?

It is important to seek immediate medical attention if you are experiencing chronic stomach ache, nausea, and severe headache during your pregnancy, especially if you have a history of preterm labor. While it is not possible for me to diagnose your condition, I can provide some general information about the potential causes of these symptoms and what to expect during the evaluation process:

1. Abdominal Pain: Chronic stomach pain during pregnancy can have various causes, such as:

- Braxton Hicks contractions (false labor pains)

- Round ligament pain (stretching of the ligaments supporting the uterus)

- Preeclampsia (a pregnancy-related condition characterized by high blood pressure and protein in the urine)

- Placental abruption (premature separation of the placenta from the uterine wall)

2. Nausea: Nausea is a common symptom during pregnancy, often referred to as "morning sickness." However, persistent and severe nausea may be a sign of an underlying medical condition.

3. Headache: Headaches are also common during pregnancy, but severe headaches that do not resolve with over-the-counter pain relievers or are accompanied by other concerning symptoms should be evaluated promptly. This is because they can sometimes indicate a more serious medical condition.

4. Cerclage: A cerclage is a surgical procedure performed to help prevent preterm labor by reinforcing the cervix. If you are experiencing pain or a sensation of tearing near the cervix, it is essential to seek medical evaluation as soon as possible.

5. Preterm Labor: Given your history of preterm labor, it is crucial to monitor for signs of recurrent preterm labor, which can include:

- Regular uterine contractions

- Increased vaginal discharge or fluid leaks

- Lower backache

- Pelvic pressure

- Menstrual-like cramps

- A change in the shape of the abdomen

Evaluation Process:

1. Medical History and Physical Examination: Your healthcare provider will review your medical history, including your pregnancy history and any relevant symptoms. A physical examination will be performed to assess your overall condition, including blood pressure, abdominal evaluation, and cervical examination (if appropriate).

2. Diagnostic Tests: Based on your symptoms and the assessment, your healthcare provider may recommend diagnostic tests, such as:

- Blood tests (to check for infections or other medical conditions)

- Urine tests (to assess kidney function and check for protein)

- Ultrasound (to evaluate the position of the placenta, cervix, and assess for abnormalities)

- Non-stress test or biophysical profile (to monitor fetal well-being)

3. Differential Diagnosis: Your healthcare provider will work to establish a differential diagnosis by considering the potential causes of your symptoms and ruling out any serious medical conditions.

It is important to seek prompt evaluation and follow-up care as recommended by your healthcare provider to ensure the safety of both you and your baby.

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