Dejavniki tveganja bolečine v križu in/ali medeničnem obroču med nosečnostjo : diplomsko delo

Pasičnjek, Ines (author), Divjak, Mojca (mentor), Hiti, Nina (co-mentor)

Uvod: Poleg psihosocialnih sprememb nosečnost izzove tudi anatomske in fiziološke spremembe. V mišično-skeletnem sistemu se najpogosteje pojavita bolečina v križu in/ali bolečina v medeničnem obroču. Namen: Namen diplomskega dela je ugotoviti pogostost bolečine v križu in/ali medeničnem obroču med nosečnostjo ter vzroke in najpogostejše dejavnike tveganje, ki vplivajo na pojav bolečine. Metode dela: V diplomskem delu smo uporabili deskriptivno metodo dela s pregledom znanstvene in strokovne literature v slovenskem in angleškem jeziku. Literatura je bila iskana s pomočjo baze podatkov DiKul in tujih podatkovnih baz: Medline, CINAHL, ScienceDirect in PubMed. V analizo smo vključili 13 raziskav. Članki so bili ovrednoteni po štiristopenjski lestvici glede na moč dokazov. Rezultati: Predstavljene raziskave so potrdile pogostost bolečine v križu (razpon 32-68 %) in bolečine v medeničnem obroču (razpon 14-77 %) med nosečnostjo. Na podlagi pregleda raziskav smo ugotovili naslednje dejavnike tveganja: predhodna bolečina v ledvenem delu hrbtenice, bolečina v križu in/ali medeničnem obroču v prejšnji nosečnosti, bolečina med menstruacijo, mnogorodnost. Bolečino med nosečnostjo prav tako poslabšajo dolgotrajna stoja, dolgotrajna hoja, dolgotrajno sedenje, hoja po stopnicah, obračanje v postelji. Razprava in zaključek: Različna stopnja pogostosti bolečine v križu med različnimi državami bi delno lahko bila pojasnjena zaradi načina življenja v določeni državi. Prav tako se prevalenca lahko razlikuje med retrospektivnimi in prospektivnimi raziskavami. Pogostost bolečine v medeničnem obroču med nosečnostjo se med različnimi raziskavami razlikuje, kar je odvisno od definicije bolečine v medeničnem obroču, ki se uporablja, diagnostičnih postopkov. Pregled literature je pokazal štiri vzroke, ki vplivajo na pojav bolečine v križu in/ali medeničnem obroču: hormonske spremembe, sprememba telesne drže, biomehanske spremembe in žilne spremembe. Predstavljene raziskave so konsistentne glede dejavnikov tveganja, nasprotujoče so si samo pri dejavniku starosti. Ugotovili smo tudi, da telesna dejavnost pred in med nosečnostjo zmanjša prevalenco bolečine v križu in/ali medeničnem obroču. Ker so težave z bolečino v križu in/ali medeničnem obroču med nosečnostjo večkrat spregledane in posledično vodijo v razvoj kronične bolečine v križu in/ali medeničnem obroču po porodu, bi bilo priporočljivo ženske z bolečino v križu in/ali medeničnem obroču že v času nosečnosti napotiti do ustreznih strokovnjakov.

• Language: Slovenian
• Keywords: mišično-skeletne težave, nosečnica, vzroki, prevalenca
• Work type: Bachelor thesis/paper
• Organization: ZF - Faculty of Health Sciences
• Year: 2018
• PID: 20.500.12556/RUL-103798
• COBISS.SI-ID: 5497451
• Publication date in RUL: 26.09.2018

Secondary language

• Language: English
• Title: Risk factors for low back pain and/or pelvic pain during pregnancy : diploma work

Abstract

Introduction: In addition to psychosocial changes, pregnancy also provokes anatomical and physiological changes. The most common musculoskeletal problem during pregnancy is low back pain and/or pelvic girdle pain. Aim: The aim of the thesis is to determine the prevalence of low back pain and/or pelvic girdle pain during pregnancy, its causes and the most common risk factors that affect the occurrence of pain. Methods: The descriptive method with an overview of domestic and foreign scientific and professional literature was used. The literature was found using the DiKul database and foreign databases: Medline, CINAHL, ScienceDirect and PubMed. The analysis included 13 studies. The articles were evaluated on a four level scale based on the strength of the evidence. Results: The presented studies confirmed the prevalence of low back pain (range 32-68 %) and pelvic girdle pain (range 14-77 %) during pregnancy. Based on a review of researches, we identified the following risk factors: previous pain in the lumbar spine, low back pain and/or pelvic girdle pain during previous pregnancy, pain during menstruation, parity. Pain during pregnancy also worsens due to long-term standing, long-term walking, long-term sitting, walking on stairs and turning in bed. Discussion and conclusion: The different level of prevalence of low back pain between different countries could partially be explained by the lifestyle in specific countries. The prevalence may also vary between retrospective and prospective studies. The prevalence of pelvic girdle pain during pregnancy varies between different studies, depending on the used definition of pelvic girdle pain and the diagnostic procedures. The literature review has identified four causes that affect the occurrence of low back pain and/or pelvic girdle pain: hormonal changes, changes in the body posture, biomechanical changes and vascular changes. The presented studies are consistent about the risk factors; they only disagree about age as a risk factor. We also found that physical activity before and during pregnancy reduced the prevalence of pain in the lower back and/or pelvic girdle. Because problems with low back pain/and or pelvic girdle pain during pregnancy are overlooked and consequently lead to the development of chronic low back pain and/or pelvic girdle pain after delivery, it would be advisable for women with low back pain and/or pelvic girdle pain that they already during pregnancy refer to relevant experts.

• Keywords: musculoskeletal problems, pregnant woman, causes, prevalence