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Orthopedic issues in pregnancy.

Micah Warren Smith1, Peter S Marcus, L Daniel Wurtz

  • 1Ft. Wayne Medical Education Program, Ft. Wayne, Indiana, USA.

Obstetrical & Gynecological Survey
|January 18, 2008
PubMed
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Pregnancy causes significant musculoskeletal stress, leading to various orthopedic issues. While most pregnancy-related orthopedic problems are manageable conservatively, some may necessitate emergency surgery.

Area of Science:

  • Orthopedics
  • Obstetrics
  • Musculoskeletal Medicine

Background:

  • Pregnancy significantly impacts the maternal musculoskeletal system due to anatomical and hormonal changes.
  • The enlarging uterus shifts the center of gravity, increasing mechanical stress on the spine and pelvis.
  • Hormonal fluctuations and fluid retention further exacerbate musculoskeletal strain during pregnancy.

Purpose of the Study:

  • To provide a comprehensive overview of orthopedic problems encountered during pregnancy.
  • To discuss the pathogenesis, clinical presentation, diagnosis, and management of these conditions.
  • To cover specific conditions affecting the spine, pelvis, hip, and wrist.

Main Methods:

  • Review of pregnancy-related orthopedic conditions.

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  • Discussion of pathogenesis, signs, symptoms, and physical examination findings.
  • Outline of diagnostic work-up and intervention strategies, including conservative and surgical options.

    • Main Results:

    • Pregnancy-related posterior pelvic pain (PRPPP), lumbar disc herniation with cauda equina syndrome, and low back pain are common.
    • Conditions like pubic symphysis rupture, transient osteoporosis, osteonecrosis, and carpal tunnel syndrome are also addressed.
    • Management strategies range from conservative care to emergent surgical intervention for specific conditions.

    Conclusions:

    • Musculoskeletal issues are a significant concern during pregnancy, requiring careful evaluation and management.
    • A range of orthopedic problems can arise, necessitating tailored interventions.
    • Early diagnosis and appropriate treatment are crucial for managing pregnancy-related orthopedic conditions effectively.