Understanding peripartum pelvic pain - Implications of a patient survey
Understanding peripartum pelvic pain - Implications of a patient survey
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DOI：
10.1097/00007632-199606010-00017
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发表时间：
1996-06-01
期刊：
影响因子：
3
通讯作者：
Snijders, CJ
中科院分区：
文献类型：
--
作者：
Mens, JMA;Vleeming, A;Snijders, CJ
研究设计。目的对围产期盆腔疼痛患者的自述病史进行分析。编制一份围产期盆腔疼痛患者的残疾清单，分析与疾病发展风险相关的因素，并就发病机制和具体的预防和治疗措施提出假设。怀孕是慢性下腰痛的重要危险因素。了解妊娠和分娩期间盆腔和下腰痛的发病机制，有助于了解和处理非特异性下腰痛。通过问卷的方式，收集了荷兰盆腔抱怨患者协会患者中与联合松解术相关的背景数据。将结果与普通人群进行比较。亚组间比较。围产期盆腔疼痛严重干扰了我们日常生活中的许多活动，如站立、行走、坐着，以及所有其他涉及骨盆的活动。大多数患者在月经前后和随后怀孕期间会复发。围产期盆腔疼痛的发生与双胎妊娠、首次妊娠、初孕年龄较大、婴儿体重较大、产钳或负压拔除、眼底表现、产妇分娩时体位弯曲等因素有关，与剖宫产呈负相关。据推测，围产期盆腔疼痛是由于韧带损伤(最近或过去)、荷尔蒙效应、肌肉无力和胎儿体重的综合作用而导致的骨盆和下脊柱韧带拉伤。
Study Design. An analysis was made of the self-reported medical histories of patients with peripartum pelvic pain.Objectives. To compile an inventory of the disabilities of patients with peripartum pelvic pain, analyze factors associated with the risk for development of the disease, and to formulate a hypothesis on pathogenesis and specific preventive and therapeutic measures.Summary of Background Data. Pregnancy is an important risk factor for development of chronic low back pain. Understanding the pathogenesis of pelvic and low back pain during pregnancy and delivery could be useful in understanding and managing nonspecific low back pain.Methods. By means of a questionnaire, background data were collected among patients of the Dutch Association for Patients With Pelvic Complaints in Relation to Symphysiolysis. Results were compared with the general population. Subgroups were compared with each other.Results. Peripartum pelvic pain seriously interferes with many activities of daily living such us standing, walking, sitting, and all other activities in which the pelvis is involved. Most patients experience a relapse around menstruation and during a subsequent pregnancy. Occurrence of peripartum pelvic pain was associated with twin pregnancy, first pregnancy, higher age at first pregnancy, larger weight of the baby, forceps or vacuum extraction, fundus expression, and a flexed position of the woman during childbirth; a negative association was observed with cesarean section.Conclusions. It is hypothesized that peripartum pelvic pain is caused by strain of ligaments in the pelvis and lower spine resulting from a combination of damage to ligaments (recently or in the past), hormonal effects, muscle weakness, and the weight of the fetus.