Pelvic girdle pain during pregnancy is more likely to persist after cesarean section than after unassisted vaginal delivery, Norwegian researchers say.
Dr Elisabeth K Bjelland of the Norwegian Institute of Public Health, Oslo, lead author of a new study, told Reuters Health by e-mail that pelvic girdle pain during pregnancy has been associated with higher rates of planned cesarean section.
To study the association between mode of delivery and pain in the anterior and bilateral posterior pelvis - persistent pelvic girdle pain syndrome - at six months postpartum, Dr Bjelland and colleagues used questionnaires completed by almost 72 000 women during the first and third trimesters and at six months after delivery.
How the study was done
From that cohort they identified 10 400 women who had singleton pregnancies and had reported the syndrome at 30 weeks gestation.
As reported online in the American Journal of Obstetrics and Gynecology, planned cesarean section was associated with severe pain at six months postpartum (adjusted odds ratio, 2.3).
In addition, persistent pain at six months was strongly associated with use of crutches in pregnancy week 30. In the 25.1% of women who used crutches during pregnancy, the adjusted odds ratio was 2.0 for emergency cesarean section and 3.3 for the planned procedure.
"Among women with severe pelvic girdle pain and dysfunction, preference for a planned caesarean section may seem reasonable," the authors wrote. "However, our results do not suggest that caesarean section represents a benefit for the process of recovery from pelvic girdle pain."
Two- to threefold increased risk
In fact, Dr Bjelland said, "We found a two- to threefold increased risk of severe persistent pelvic girdle pain postpartum in women who undergo a caesarean section compared to unassisted vaginal delivery. When deciding the mode of delivery, obstetricians should be aware of the increased risk of non-recovery after cesarean section among women presenting with severe pelvic girdle pain."
"When counselling women with severe pelvic girdle pain about delivery mode," she continued, "the increased risk of severe persistent pelvic girdle pain after cesarean section is of importance. If there are no medical or obstetrical indications for a cesarean section, our results suggest that vaginal delivery is the preferred mode of delivery also for women with severe pelvic girdle pain."
(David Douglas, Reuters Health, December 2012)
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