Pelvic pain in pregnancy : Studies on symphyseal distension, serum relaxin levels and the influence of living conditions

Abstract: Symphyseal width was assessed in 15 non-pregnant females using radiography and ultrasonography. Regression equation: y = 0.98x + 0.30 (mm), r2 = 0.72. The latter technique was used in subsequent studies.Symphyseal width at onset of labour in 24 women was on average 6.0 mm for those with and 5.5 mm for those without pelvic pain. A second measurement was obtained from 16 of those women when the fetal head was at the ischiadic spines. The average symphyseal distension was 0.2 mm and 1.1 mm, respectively (p=0.02).In a cohort of 49 women, symphyseal width was assessed at 12 and 35 weeks of pregnancy and at 5 months post partum. Those with disabling pain during pregnancy and none at follow-up (n=6) had wider symphyses as 35 weeks (6.3 mm) than controls (n=33) (4.5 mm) (p<0.001).A cross-sectional analysis at 35 weeks of pregnancy of the above 49 women and 19 consecutive referral cases with severe pelvic pain, showed a mean symphyseal with of 4.5 mm for controls (n=38), compared to 5.7 mm for cohort cases with disabling pain (n=11) (p=0.044) and 7.4 mm for referral cases (p<0.0001). However, the degree of symphyseal distension did not predict the level of symptoms in the individual case. Serum relaxin levels were not associated with symphyseal distension or disabling pain.The prevalence, degree and location of pelvic pain in pregnancy was investigated in 752 women in two Scandinavian cities and in an African urban and rural setting. The results indicate, that pelvic pain in pregnancy is not dependent on living conditions.

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