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首页> 美国卫生研究院文献>Facts Views Vision in ObGyn >Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal
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Pelvic Girdle Pain during or after Pregnancy: a review of recent evidence and a clinical care path proposal

机译：妊娠期间或之后的骨盆带疼痛：近期证据回顾和临床护理路径建议

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Problem statement: Pelvic girdle pain (PGP) is a common condition during or after pregnancy with pain and disability as most important symptoms. These symptoms have a wide range of clinical presentation. Most doctors perceive pregnancy related pelvic girdle pain (PPGP) as ‘physiologic’ or ‘expected during pregnancy’, where no treatment is needed. As such women with PPGP mostly experience little recognition. However, many scientific literature describes PPGP as being severe with considerable levels of pain and disability and socio-economic consequences in about 20% of the cases.Objectives: We aimed to (1) inform the gynecologist/obstetrician about the etiology, diagnosis, risk factors, and treatment options of PPGP and (2) to make a proposition for an adequate clinical care path.Methods: A systematic search of electronic databases and a check of reference lists for recent researches about the diagnosis, etiology, risk factors and treatment of PPGP.Results: Adequate treatment is based on classification in subgroups according to the different etiologic factors. The various diagnostic tests can help to make a differentiation in the several pelvic girdle pain syndromes and possibly reveal the underlying biomechanical problem. This classification can guide appropriate multidimensional and multidisciplinary management. A proposal for a clinical care path starts with recognition of gynecologist and midwife for this disorder. Both care takers can make a preliminary diagnosis of PPGP and should refer to a physiatrist, who can make a definite diagnosis. Together with a physiotherapist, the latter can determine an individual tailored exercise program based on the influencing bio-psycho-social factors.
机译：问题陈述：骨盆带疼痛（PGP）是怀孕期间或之后的常见病，疼痛和残疾是最重要的症状。这些症状具有广泛的临床表现。大多数医生认为与妊娠相关的骨盆带痛（PPGP）为“生理性”或“妊娠期预期”，不需要治疗。因此，患有PPGP的女性大多鲜为人知。然而，许多科学文献将PPGP视为严重疾病，在大约20％的病例中有相当程度的疼痛和致残以及社会经济后果。目的：我们旨在（1）向妇科医生/产科医生告知病因，诊断，风险方法：对电子数据库进行系统搜索并查阅参考文献清单，以获取有关PPGP的诊断，病因，危险因素和治疗的最新研究方法；以及（2）提出适当的临床护理路径的命题。结果：适当的治疗是根据不同病因对亚组进行分类。各种诊断测试可以帮助区分几种骨盆带疼痛综合征，并可能揭示潜在的生物力学问题。这种分类可以指导适当的多维和多学科管理。关于临床护理的建议始于对这种疾病的妇科医生和助产士的认可。两位护理人员都可以对PPGP进行初步诊断，并应咨询可以明确诊断的物理医生。后者可以与物理治疗师一起根据影响生物心理社会因素来确定个性化的锻炼计划。

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