Sonographic assessment of symphyseal joint distention during pregnancy andpost partum with special reference to pelvic pain

Citation
K. Bjorklund et al., Sonographic assessment of symphyseal joint distention during pregnancy andpost partum with special reference to pelvic pain, ACT OBST SC, 78(2), 1999, pp. 125-130
Citations number
28
Categorie Soggetti
Reproductive Medicine
Journal title
ACTA OBSTETRICIA ET GYNECOLOGICA SCANDINAVICA
ISSN journal
00016349 → ACNP
Volume
78
Issue
2
Year of publication
1999
Pages
125 - 130
Database
ISI
SICI code
0001-6349(199902)78:2<125:SAOSJD>2.0.ZU;2-G
Abstract
Objective. To elucidate whether there is a relationship between pregnancy-r elated pelvic pain and degree of symphyseal laxity. Methods. Forty-nine women were interviewed and examined and ultrasonographi c measurement of symphyseal width and vertical shift was conducted at 12 an d 35 weeks of pregnancy and at 5 months post partum. The patients were retr ospectively classified into four groups on the basis of presence and degree of pain in late pregnancy and presence or absence of pain at follow up. Results. The prevalence of pelvic pain of any degree during pregnancy was 4 9%, of pronounced pain 16.3% and of severe pain 6.1%. Nineteen percent had any remaining pain at 5 months post partum. The median symphyseal width at 12 and 35 weeks of pregnancy and at 5 months post partum was 3.5 mm, 4.6 mm and 2.8 mm, the median vertical shift 0.0 mm, 0.8 and 0.9 mm respectively. Those with disabling pain during pregnancy and no pain at follow up had gre ater symphyseal width (6.3 mm) and vertical shift (1.8 mm) at 35 weeks of p regnancy than controls; 4.5 mm (p<0.01) and 0.5 mm (p<0.01) respectively. T hose with disabling pain during pregnancy and persistent pain at follow up did not differ significantly from controls in symphyseal width or shift. Th e most severe cases were in this group. Conclusion. There is a minor pregnancy-induced physiological increase in la xity of the symphyseal soft tissue. There is no evidence that the degree of symphyseal distention determines the severity of pelvic pain in pregnancy or after childbirth.