DOI: https://doi.org/10.15674/0030-59872020361-66

Pelvic-spine pain at pregnancy: diagnostics and treatment

Volodymyr Tankut, Kostiantyn Berenov, Olga Berenova

Abstract


The course of pregnancy is often complicated by pelvic spine pain (PSP), which leads to household and occupational disability, negatively affects the condition of the fetus and the unborn child. Objective: to analyze the main factors in the development of PSP in pregnant women, to improve the methods of diagnosis and treatment. Methods: the protocols of clinical, biomechanical and ultrasound examinations of 175 women of reproductive age (18–45 years old) with PSP were studied. The following structural sources of pain were identified: facet joints, sacroiliac joints, and hip joints, intervertebral discs, pubic joints, and myofascial structures. Each type of pain was classified according to the nature of the pain syndrome. Results: mapsschemes of sources and variants of pain syndromes localization were proposed. There were 4 main factors in the development of lumbar pain syndrome (instability (40.8 %), facet joints pain, diskalgia (5.1 %), functional blockade of the lumbar vertebral motor segments (26.3 %)), 5 — pelvic (instability joints (39.5 %), arthralgia (23 %), functional blockade (40.8 %), syndromes of the sacroiliac joints (80 %) and symphysitis (48.7 %)). Basic treatment programs for pregnant women with PSP have been developed, the use of which led to a decrease in pain intensity during pregnancy by an average of 75 %. Some of the positive results of rehabilitation increased from (70.11 ± 16.42) % in the first trimester to (75.80 ± 18.43) % in the third. The rehabilitation index was (81.49 ± 19.26) %. Conclusions: PSP in pregnant women differs from pain at degenerative spine diseases and pelvic. The proposed working charts-schemes of different types of sources and variants of localization of pain syndromes significantly improved the diagnosis of these pathological conditions, which helped to determine the treatment method. The effectiveness and expediency of using the developed program for the treatment of pregnant women with PSP in medical practice has been confirmed.

Keywords


: pregnant women; lumbar-pelvic pain; factors; methods of prevention and treatment

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