Persistent pelvic pain and pelvic joint instability.

Area of Science:

• Obstetrics and Gynecology
• Reproductive Health
• Musculoskeletal Disorders

Background:

• Pelvic pain and pelvic joint instability (PPPJI) is a recognized condition during pregnancy.
• The diagnosis of PPPJI in non-pregnant women remains controversial and often doubted.
• A patient association for women suffering severe, incapacitating PPPJI post-childbirth presents a unique research opportunity.

Purpose of the Study:

• To investigate the characteristics of women experiencing chronic pelvic pain and pelvic joint instability (PPPJI) following childbirth.
• To identify potential contributing factors and associated conditions in women with PPPJI.
• To compare characteristics of women with PPPJI to controls.

Main Methods:

• A questionnaire was administered to 153 members of a PPPJI patient association.
• Data collected included onset of PPPJI, pregnancy history, lifestyle, prior medical conditions, and reproductive history.
• Delivery characteristics and offspring data were analyzed.

Main Results:

• The majority of women (110/153) experienced PPPJI during their first pregnancy, with onset before 20 weeks gestation in 84 women.
• Onset of PPPJI was significantly earlier in oral contraceptive users (16.3 weeks) compared to non-users (20.5 weeks).
• Deliveries were characterized by excess post-term births, a higher proportion of infants >4000g, an extremely low sex ratio (0.84), and increased congenital hip dysplasia rates.

Conclusions:

• Women with chronic PPPJI exhibit distinct characteristics and pregnancy outcomes.
• The findings suggest a potential link to elevated estrogen and relaxin levels.
• Further research is warranted to understand the pathophysiology and management of PPPJI in non-pregnant women.