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Journal of Advanced Nursing Aug 2022To describe the care needs of women with pregnancy-related pelvic girdle pain based on the Caring Life-Course Theory.
AIMS
To describe the care needs of women with pregnancy-related pelvic girdle pain based on the Caring Life-Course Theory.
DESIGN
A descriptive qualitative research design.
METHODS
Data were collected between November 2019 and February 2021 from 20 purposively selected pregnant women with pelvic girdle pain aged between 22 and 39 years in antenatal care at a tertiary hospital in Australia. Individual semi-structured interviews were recorded via a digital audio recorder and transcribed verbatim. Qualitative content analysis method was used to analyse the data.
FINDINGS
Five broad themes were identified: pain is an added burden to pregnancy; knowledge is power to own what happens to me; engaging in self-help; care from others is useful; and pain deserves more attention from healthcare professionals.
CONCLUSION
Caring Life-Course Theory presented a useful and applicable scaffold for describing care needs of pregnant women with pelvic girdle pain. The study revealed experiencing pelvic girdle pain led to additional care needs during pregnancy, highlighting the importance of self-management strategies and an appreciation of care from others to assist women in limiting the effects of the pain. Participants identified the need for more information and attention from healthcare professionals to be able to better manage their condition.
IMPACT
This study presents a comprehensive picture of the change in care needs triggered by experiencing pelvic girdle pain during pregnancy. The findings have the potential to facilitate better care provision by considering novel methods of delivery, such as information and communication technology, whilst acknowledging the value placed on credible and trusted sources. Knowledge acquired through this study may be used by nurses and midwives, along with other healthcare professionals, to enhance the provision of comprehensive care that is acceptable to women with pelvic girdle pain during pregnancy.
Topics: Adult; Female; Humans; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Pregnant Women; Prenatal Care; Qualitative Research; Young Adult
PubMed: 35301748
DOI: 10.1111/jan.15229 -
BJOG : An International Journal of... Dec 2015To study the associations of patterns and duration of breastfeeding with the persistence of pelvic girdle pain 18 months after delivery.
OBJECTIVE
To study the associations of patterns and duration of breastfeeding with the persistence of pelvic girdle pain 18 months after delivery.
DESIGN
Longitudinal population study.
SETTING
Norway, for the period 1999-2011.
POPULATION
A follow-up of 10 603 women with singleton deliveries in the Norwegian Mother and Child Cohort Study who reported pelvic girdle pain at 0-3 months postpartum.
METHODS
Data were obtained by four self-administered questionnaires and linked to the Medical Birth Registry of Norway.
MAIN OUTCOME MEASURE
Pelvic girdle pain, defined as combined anterior and bilateral posterior pelvic pain, 18 months after delivery.
RESULTS
Eighteen months after delivery, 7.8% of respondents (829/10,603) reported pelvic girdle pain. Breastfeeding patterns at 5 months after delivery were not associated with persistence of pelvic girdle pain. The proportion of women with pelvic girdle pain 18 months after delivery increased as the duration of breastfeeding decreased (test for trend, P < 0.001). The estimated associations attenuated after adjustment for educational level, smoking status, and body mass index, but remained statistically significant for the association between 0 and 2 months of breastfeeding and persistent pelvic girdle pain (adjusted odds ratio 1.34; 95% confidence interval 1.03-1.75). The association of short breastfeeding duration with persistent pelvic girdle pain was only present in women with body mass index ≥25 kg/m(2) .
CONCLUSIONS
Breastfeeding was associated with a small beneficial effect on the recovery process of pelvic girdle pain in women with a body mass index ≥25 kg/m(2) . Among women with pelvic girdle pain, breastfeeding should be encouraged in accordance with the existing child-feeding recommendations.
Topics: Adult; Breast Feeding; Female; Follow-Up Studies; Humans; Longitudinal Studies; Norway; Pelvic Girdle Pain; Postpartum Period; Pregnancy; Pregnancy Complications; Risk Factors; Surveys and Questionnaires
PubMed: 25327939
DOI: 10.1111/1471-0528.13118 -
Journal of Nepal Health Research Council Mar 2022Pregnant women with health problems have shown higher odds of depressive symptoms. Evidence suggests a co-morbid relation between pregnancy-related low back pain and/or...
BACKGROUND
Pregnant women with health problems have shown higher odds of depressive symptoms. Evidence suggests a co-morbid relation between pregnancy-related low back pain and/or pelvic girdle pain and the risk of depression. The aims were to investigate the prevalence of symptoms of depression among pregnant Nepalese women in general and among pregnant Nepalese women with low back pain and/or pelvic girdle pain and to identify factors associated to symptoms of depression.
METHODS
A cross-sectional study using standardized condition-specific questionnaires with response from 1284 pregnant Nepalese women. Multivariate logistic regression analysis determined variables associated with symptoms of depression.
RESULTS
Twenty-one percent of the women presented with moderate to high symptom level of depression, compared to 29% of the women with low back pain and/or pelvic girdle pain. Low education, living without husband, no rest during work, higher self-reported disability, higher pain intensity and symptoms of pelvic organ prolapse were associated with higher odds of symptoms of depression among the women with low back pain and/or pelvic girdle pain. For the total sample, fetching water and having symptoms of low back pain and/or pelvic girdle pain and living without husband were associated to symptoms of depression.
CONCLUSIONS
Twenty-one percent of the pregnant women reported moderate to high symptom level of depression. The proportion of women with symptoms of depression was significantly higher among the women categorized as having low back pain and/or pelvic girdle pain. Our findings highlight the need to address both emotional and physical needs among pregnant Nepalese women.
Topics: Cross-Sectional Studies; Depression; Female; Humans; Low Back Pain; Nepal; Pelvic Girdle Pain; Pregnancy; Pregnancy Complications; Pregnant Women; Prevalence
PubMed: 35615838
DOI: 10.33314/jnhrc.v19i04.3849 -
BMC Women's Health Sep 2020Pelvic girdle pain is a common problem during pregnancy. For most women, the symptoms cease within the first 3-6 months of giving birth, but in some women the pain...
BACKGROUND
Pelvic girdle pain is a common problem during pregnancy. For most women, the symptoms cease within the first 3-6 months of giving birth, but in some women the pain persists. In this study we investigate the sexuality and frequency of depressive symptoms in women with persistent pelvic girdle pain after childbirth and in healthy women.
METHODS
We conducted a case-control study of women with persistent pelvic girdle pain after childbirth and a control group of healthy women. The frequency of depressive symptoms and sexuality were measured using the self-rating version of the Montgomery-Asberg Depression Rating Scale and the McCoy Female Sexuality Questionnaire.
RESULTS
Forty-six women with persistent pelvic girdle pain and thirty-nine healthy women were enrolled. The frequency of depressive symptoms and the total score on female sexuality did not differ between the groups. However, pain during intercourse was more frequent (P < 0.001) in women with persistent pelvic girdle pain and caused them to avoid sexual intercourse frequently (P < 0.001). In multiple linear regression a higher frequency of depressive symptoms was reversely correlated with a lower score on female sexuality (β - 0,41, p < 0,001 95% CI -0,6 - -0,22) This association remained after adjusting for obstetric variables and individual characteristics.
CONCLUSION
Depressive symptoms and female sexuality were similar between women with persistent pelvic girdle pain after childbirth and healthy controls. However, pain during intercourse and avoidance of sexual intercourse were more frequent among women with pelvic girdle pain.
Topics: Affect; Case-Control Studies; Cesarean Section; Depression, Postpartum; Female; Humans; Low Back Pain; Pelvic Girdle Pain; Pelvic Pain; Postpartum Period; Pregnancy; Pregnancy Complications; Sexuality; Treatment Outcome
PubMed: 32928204
DOI: 10.1186/s12905-020-01058-7 -
Journal of Back and Musculoskeletal... 2013During pregnancy or postpartum period, several women experience some degree of pelvic girdle pain (PGP). In India, information is lacking about the prevalence and...
BACKGROUND AND OBJECTIVES
During pregnancy or postpartum period, several women experience some degree of pelvic girdle pain (PGP). In India, information is lacking about the prevalence and possible risk factors of PGP evaluated during postpartum period. This study aims to determine the prevalence of PGP in postpartum women who underwent vaginal or caesarean mode of delivery and to estimate possible associated factors with or without PGP in both modes of deliveries.
METHODS
In this cross-sectional study, 284 postpartum women answered questionnaires and underwent clinical examinations. Clinical examination included pain provocation tests for the pelvis as well as the active straight leg raise (ASLR) test. Probable associated factors were studied using non-parametric tests and logistic regression analysis.
RESULTS
In this study of 284 women, 41% reported pain in the pelvic girdle during postpartum period. Overall, 33% of the women experienced PGP after caesarean delivery as compared with 8.3% of women after vaginal delivery. Low back pain (LBP) before pregnancy, parity, active straight leg raise test score ≥ 4, bilateral P4 test, and sitting position during breast-feeding were significantly associated with vaginal delivery group and caesarean delivery group during postpartum period. In both modes of delivery, the association of PGP with these common factors remained after adjustment for other study factors.
CONCLUSION
We found high prevalence of PGP in women who had caesarean delivery than those who had a vaginal delivery. Our finding suggests that, during postpartum period, LBP before pregnancy, parity, ASLR test score ≥ 4, bilateral P4 test, and sitting position during breast-feeding were significantly associated with increased risk of PGP in both vaginal and caesarean modes of deliveries, but further studies are needed for definitive conclusions.
Topics: Adult; Breast Feeding; Cross-Sectional Studies; Delivery, Obstetric; Female; Humans; Logistic Models; Low Back Pain; Neurologic Examination; Parity; Parturition; Pelvic Pain; Postpartum Period; Posture; Pregnancy; Young Adult
PubMed: 23893143
DOI: 10.3233/BMR-130378 -
Physical Therapy Apr 2024The objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and...
OBJECTIVE
The objective of this study was to evaluate whether early postpartum exercise is associated with changes in pelvic symptom severity, pelvic floor muscle strength, and diastasis recti abdominis (DRA) from 3 to 12 months postpartum.
METHODS
In this prospective cohort study, 504 participants with and without pelvic symptoms (pelvic girdle pain, stress urinary incontinence, vaginal heaviness) were followed. At 3, 6, 9, and 12 months postpartum, we assessed pelvic symptoms, exercise behavior (by questionnaires), pelvic floor muscle strength (by vaginal palpation), and DRA (by caliper measurement). Based on the 3-months questionnaire, participants were categorized as nonexercisers (n = 105), minimal low-impact exercisers (n = 249), regular low-impact exercisers (n = 117), and high-impact exercisers (n = 32). Between-group differences and within-group changes from 3 to 12 months were calculated using Chi-square tests, Kruskal-Wallis tests, and Friedman analysis of variance.
RESULTS
At 3 months, no differences in symptom prevalence were seen between the groups. Nonexercisers reported higher pelvic girdle pain severity and had weaker pelvic floor muscles. The within-group analysis showed that pelvic girdle pain severity did not change in nonexercisers or high-impact exercisers, but decreased in minimal and regular low-impact exercisers. Stress urinary incontinence increased in nonexercisers from 3 to 12 months, while it remained unchanged in regular low-impact and high-impact exercisers, and decreased in minimal low-impact exercisers. Across all groups, vaginal heaviness and DRA decreased, and pelvic floor strength increased from 3 to 12 months.
CONCLUSION
The study indicates that early low-impact exercising is associated with reduced pelvic girdle pain severity during the first postpartum year. Minimal low-impact exercisers also showed a slight reduction in stress urinary incontinence. Conversely, nonexercisers reported an increase in stress urinary incontinence between 3 and 12 months postpartum.
IMPACT
Physical therapists should encourage women to start with low-impact exercise early after pregnancy.
LAY SUMMARY
This study highlights the positive effects of starting gentle, low-impact exercise early after childbirth to reduce pelvic girdle pain and urinary incontinence.
Topics: Female; Humans; Pregnancy; Diastasis, Muscle; Muscle Strength; Pelvic Floor; Pelvic Girdle Pain; Prospective Studies; Rectus Abdominis; Urinary Incontinence, Stress; Exercise; Longitudinal Studies
PubMed: 38109793
DOI: 10.1093/ptj/pzad171 -
Physiotherapy Theory and Practice Oct 2023Persistent pregnancy-related pelvic girdle pain (PGP) and the resulting consequences may considerably influence a woman's quality of life. The complexity of this...
BACKGROUND
Persistent pregnancy-related pelvic girdle pain (PGP) and the resulting consequences may considerably influence a woman's quality of life. The complexity of this condition requires a whole-person centered approach. In response to COVID-19 outbreak, telerehabilitation has emerged as a promising alternative to traditional in-person visits.
PURPOSE
The aim of this report was to present the potential of telerehabilitation for persistent postpartum PGP within the biopsychosocial framework.
CASE DESCRIPTION
A 26-year-old female presented with persistent pregnancy-related PGP of 8 months duration after her first vaginal delivery. The video-consults were performed using telerehabilitation platform. The patient received six telerehabilitation consults of 45 min duration over five weeks. Assessment of physical and psychosocial factors, cognitively focused strategies including pain neurophysiology education, sensory-motor remapping exercises, and graded increase of activity were administered. Rehabilitation was divided into the following phases: assessment, desensitization, graded exposure, and supported independence.
OUTCOMES
The Pelvic Girdle Questionnaire (PGQ) score was significantly reduced from 72.2 during the assessment to 15.3 at discharge. This change was significantly more substantial than the minimal clinically important change estimated for the PGQ.
CONCLUSION
Physiotherapists can utilize telerehabilitation to assist them with enacting appropriate care measures for persistent PGP within a biopsychosocial framework.
Topics: Pregnancy; Female; Humans; Adult; Pelvic Girdle Pain; Telerehabilitation; Quality of Life; Pain Measurement; COVID-19; Postpartum Period; Pregnancy Complications
PubMed: 35481796
DOI: 10.1080/09593985.2022.2069618 -
Der Unfallchirurg Apr 19921566 patients with fractures of the pelvis were treated at the Department of Traumatology of the Hannover Medical School between 1972 and 1990: 1350 patients had... (Review)
Review
1566 patients with fractures of the pelvis were treated at the Department of Traumatology of the Hannover Medical School between 1972 and 1990: 1350 patients had fractures of the pelvic ring, 216 isolated acetabulum fractures, 398 combinations of pelvic ring fractures and acetabular involvement; 718 of these patients were admitted with severe polytrauma. For 1254 patients a complete file was available for clinical and radiological evaluation of fracture distribution, classification (Tile and anatomical location) and concomitant injuries. During the observation period, significant increase in the severity of the trauma, the severity of the pelvic fractures and the rate of internal stabilization, especially of the posterior pelvic ring was observed. The overall mortality after pelvic fractures was 18.1%. This mortality depended significantly on the Hannover Polytrauma Score (PTS) and the associated pelvic and extrapelvic blunt trauma. Internal fixation of pelvic fractures was performed in 195 patients. This experience has now led to standardized procedures for the different fracture locations. With the task of minimizing soft tissue trauma and reducing the implant size, more differentiated treatment of sacral fractures is now applied. Adapted small fragment implants ("local osteosyntheses") can be applied, with an unilateral longitudinal dorsal incision providing an excellent overview over the fracture line. For internal fixation of sacral fractures, involvement (penetration by screws, transfixation) of the sacroiliac joint is avoided whenever possible. In our experience early open reduction and internal fixation of pelvic fractures facilitates the management of these severely injured patients.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Bone Plates; Bone Screws; Child; Child, Preschool; Female; Follow-Up Studies; Fracture Fixation, Internal; Humans; Male; Middle Aged; Multiple Trauma; Pelvic Bones; Postoperative Complications
PubMed: 1636101
DOI: No ID Found -
European Journal of Physical and... Oct 2017
Topics: Adult; Disability Evaluation; Female; Follow-Up Studies; Humans; Interdisciplinary Communication; Middle Aged; Patient Care Team; Pelvic Girdle Pain; Physical Therapy Modalities; Psychology; Risk Assessment; Severity of Illness Index; Treatment Outcome
PubMed: 28118699
DOI: 10.23736/S1973-9087.17.04621-4 -
Acta Obstetricia Et Gynecologica... 2008Increased levels of relaxin, a hormone structurally belonging to the insulin-like growth factor family, has been associated with both pelvic girdle pain and type 1...
OBJECTIVE
Increased levels of relaxin, a hormone structurally belonging to the insulin-like growth factor family, has been associated with both pelvic girdle pain and type 1 diabetes in pregnancy. However, an association between pelvic girdle pain in pregnancy and diabetes has not been investigated. The aim of this study was to investigate whether or not an association exists between diabetes and pelvic girdle syndrome.
DESIGN
Cross-sectional questionnaire study.
SETTING
All women 18-40 years old, in two municipalities in Norway during 1998-1999 were eligible for the study. Sample. A total of 1,816 women with at least one prior delivery constituted the study sample.
METHODS
Pelvic girdle syndrome during last pregnancy was the outcome variable, defined as pain in the anterior pelvis and bilateral posterior pelvis. The impact of diabetes on developing pelvic girdle syndrome was estimated as odds ratios in logistic regression analyses.
RESULTS
Diabetes increased the risk of pelvic girdle syndrome (adjusted odds ratio 7.3; 95% confidence interval: 1.8-28.5). In addition, age > or =25 years at delivery and obesity (body mass index > or =35) were associated with pelvic girdle syndrome. Parity and time since delivery were not significantly associated with pelvic girdle syndrome.
CONCLUSIONS
The results in multivariate analyses indicate an association between pelvic girdle syndrome and diabetes. The causes of pelvic girdle pain are not known. However, our results encourage further exploration of hormonal factors.
Topics: Adolescent; Adult; Cross-Sectional Studies; Diabetes Mellitus, Type 1; Female; Humans; Logistic Models; Multivariate Analysis; Pelvic Pain; Pregnancy; Pregnancy in Diabetics
PubMed: 18763174
DOI: 10.1080/00016340802345944