The prognostic value of asymmetric laxity of the sacroiliac joints in pregnancy-related pelvic pain.
METHODS
Prospective cohort study.


OBJECTIVE
To determine the prognostic value of asymmetric laxity of the sacroiliac joints during pregnancy on pregnancy-related pelvic pain postpartum.


BACKGROUND
In a previous study, we observed a significant relation between asymmetric laxity of the sacroiliac joints and moderate to severe pregnancy-related pelvic pain during pregnancy.


METHODS
A group of 123 women were prospectively questioned and examined, and sacroiliac joint laxity was measured by means of Doppler imaging of vibrations at 36 weeks' gestation and at 8 weeks' postpartum. A left to right difference in sacroiliac joint laxity >or=3 threshold units was considered to indicate asymmetric laxity of the sacroiliac joints.


RESULTS
In subjects with moderate to severe pregnancy-related pelvic pain during pregnancy, sacroiliac joint asymmetric laxity was predictive of moderate to severe pregnancy-related pelvic pain persisting into the postpartum period in 77% of the subjects. The sensitivity, specificity, and positive predictive value of sacroiliac joint asymmetric laxity during pregnancy for pregnancy-related pelvic pain persisting postpartum were 65%, 83%, and 77%, respectively. Subjects with moderate to severe pregnancy-related pelvic pain and asymmetric laxity of the sacroiliac joints during pregnancy have a threefold higher risk of moderate to severe pregnancy-related pelvic pain postpartum than subjects with symmetric laxity.


CONCLUSIONS
These data indicate that in women with moderate to severe complaints of pelvic pain during pregnancy, sacroiliac joint asymmetric laxity measured during pregnancy is predictive of the persistence of moderate to severe pregnancy-related pelvic pain into the postpartum period.
Damen
Léonie
L
Institute of Rehabilitation Medicine, Department of Biomedical Physics and Technology, Erasmus University Rotterdam, Rotterdam, The Netherlands. leoniedamen@ hotmail.com
Buyruk
H Muzaffer
HM
Güler-Uysal
Füsun
F
Lotgering
Frederik K
FK
Snijders
Chris J
CJ
Stam
Hendrik J
HJ
D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007593:Joint Instability / Q000150:complications* / Q000000981:diagnostic imaging; D010147:Pain Measurement; D017699:Pelvic Pain / Q000209:etiology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology*; D011379:Prognosis; D011446:Prospective Studies; D012446:Sacroiliac Joint / Q000000981:diagnostic imaging / Q000473:pathology*; D018608:Ultrasonography, Doppler