Description and classification of postpartum chronic pain: A multicentric prospective study

Area of Science:

• Obstetrics and Gynecology
• Pain Medicine
• Neurology

Background:

• Persistent perineal and pelvic pain after childbirth is a significant issue.
• Current classification methods for chronic pelvic pain can be applied to postpartum pain.

Purpose of the Study:

• To classify persistent perineal and pelvic postpartum pain using established chronic pelvic pain syndromes.
• To determine the prevalence of different pain disorders in this population.
• To describe socio-demographic factors, clinical characteristics, and impact on daily function.

Main Methods:

• A prospective observational study included 40 women with chronic pain (≥3 months) linked to childbirth.
• Pain was classified using criteria for pelvic sensitization, complex regional pain syndrome, neuralgias, neuroma, thoraco-lumbar junction syndrome, myofascial pain, and fibromyalgia.
• Data collected included socio-demographics, pain characteristics, and impact on function.

Main Results:

• Neuropathic pain was diagnosed in 77.5% of participants (31/40) based on DN4 criteria.
• The most prevalent diagnoses included neuroma (17 cases), pelvic sensitization (13 cases), and myofascial pain (11 cases).
• Postpartum pain significantly impacted sexual activity (80%), defecation (38%), and micturition (28%).

Conclusions:

• The proposed classification system is effective for investigating postpartum pelvic and perineal pain.
• This classification facilitates a better understanding of the underlying pain mechanisms.
• It provides a foundation for developing targeted treatment strategies for postpartum pain.