🪢 Round Ligament Pain

🔑 Key Learning

• Common in the second trimester, especially between 12–22 weeks.
• Caused by stretching of the round ligaments as the uterus grows.
• Presents as sharp, stabbing groin pain triggered by movement.
• Diagnosis is clinical; management is conservative with reassurance and analgesia.

🧬 Pathophysiology

• The round ligaments connect the uterine horns to the labia majora via the inguinal canal.
• As the uterus enlarges during pregnancy, these ligaments stretch and thicken.
• Sudden movement (e.g. coughing, getting out of bed) can cause a brief spasm → sharp pain.

       

👀 Clinical Features

• Onset typically in the second trimester (weeks 12–22)
• Sharp or stabbing pain, often in the groin or lower abdomen (right side more common)
• Pain is worsened by:
  • Standing up quickly
  • Coughing
  • Rolling in bed
• May occur unilaterally or bilaterally

💊 Management

• Conservative measures:
  • Reassurance
  • Rest and postural adjustments
  • Avoid sudden movements
  • Maternity support belts
  • Simple analgesia (e.g. paracetamol)

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🔄 Differential Diagnosis: Pubic Symphysis Dysfunction

• Caused by pregnancy-related ligamentous laxity
• Pain localised to pubic symphysis, may radiate to groin or thighs
• Clinical features:
  • Waddling gait
  • Aggravated by walking or hip abduction

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📝 Exam Clues & Clinchers

• Pregnant woman, 2nd trimester, sudden groin pain triggered by movement → round ligament pain
• Waddling gait + pubic tenderness → consider pubic symphysis dysfunction