Dolore lombo-sacrale-pelvico in gravidanza: disabilità correlata ed esiti del parto
Notice bibliographique
Résumé
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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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».