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Tesi etd-11202018-154406


Thesis type
Tesi di laurea magistrale LM6
Author
COCCO, PAOLO
URN
etd-11202018-154406
Title
Dolore lombo-sacrale-pelvico in gravidanza: disabilità correlata ed esiti del parto
Struttura
RICERCA TRASLAZIONALE E DELLE NUOVE TECNOLOGIE IN MEDICINA E CHIRURGIA
Corso di studi
MEDICINA E CHIRURGIA
Commissione
relatore Prof. Simoncini, Tommaso
correlatore Dott. Fruscalzo, Arrigo
Parole chiave
  • Dolore lombo-sacrale-pelvico
  • gravidanza
  • disabilità
  • esiti del parto
  • Low Back pain
  • pregnancy
  • disability
  • delivery outcomes
  • Pelvic girdle pain
Data inizio appello
11/12/2018;
Consultabilità
parziale
Data di rilascio
11/12/2021
Riassunto analitico
BACKGROUND: low back pain (LBP) is a common occurrence during pregnancy. It is bound to a reduced maternal well-being during pregnancy and seems to affect negatively childbirth dynamics. Nonetheless, there are only few studies considering their impact on several childbirth outcomes such as pain perception during labor and mode of delivery. This information will potentially help obstetricians to better manage patients at risk during labor and to address early measures in affected women during pregnancy.
AIM: to better describe the LBP impact in a German sample during pregnancy and how it could impair main delivery outcomes.
METHODS: interim analysis of an observational prospective on-going study performed in an academic teaching hospital setting in Ahlen, Germany, conducted on consecutive women hospitalized for delivery.
Women undergoing an elective caesarean were excluded from study involvement.
Functional disability status related with LBP will be assessed with a self-reported questionnaire (The Quebec Pain Disability Scale, QBPDS) concerning the period before and during the three trimesters of pregnancy. Patient mobility, as well as type and amount of analgesic requirement during the three stages of labor (latent phase, first and second stage) will be reported. Main delivery outcomes including duration of labor, mode of delivery, maternal and neonatal complications will be recorded.
RESULTS:
68 women participated. 73% (49/68; IC.95: 61.48-82.28%) reported pain in the lumbopelvic region. 48% (32/68) only suffered in the lumbar region, 7% (5/68) in the pelvic area only.
Compared to the pre-pregnancy period, has been shown throughout pregnancy an important increase on VAS score and on QBPDS and a decrease in the amount of time dedicated to physical activity, as well.

Comparing women who had reported LBP in pregnancy with those who didn’t, we have noticed, in women with positive anamnesis for LBP, a statistically significant increase on QBPDS before and during pregnancy (p < .05).
In subject had suffered LBP we have noticed more caesarean sections (20,83%, n=10) and more operative deliveries (17,39%, n=8) than in control group (5,88%, n=1; 5,88%, n=1, respectively). P-value was not significant (p >.05).
In the group who has been exposed to LBP we have observed a prolonged labor in each stage, an increase of labor complications and a larger use of pain relievers, whereas no difference between the two groups has been revealed regarding maternal position during labor and neonatal outcomes. P-value has shown no significant evidence.
CONCLUSION:
LBP affects a large amount of pregnant women undergoing trial of labor. This condition interferes negatively with the activities of these women’s daily living. Even though these results are not statistically significant LBP seems to be related to a longer labor, a higher request of analgesics and an increase in the rate of caesarean and operative deliveries. Maternal position and neonatal outcomes don’t seem to be associated with LBP.
This lack of evidence is probably due to the small number of patients evaluated during this interim analysis.
The investigation is still on-going thus we have to wait until the full results to announce definitive conclusions.
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