Changes in Skeletal System during Pregnancy
Journal Title: Interventions in Gynaecology and Women’s Healthcare - Year 2018, Vol 2, Issue 1
Abstract
Pain localized at the pelvic girdle during and after pregnancy has been keyed out and registered as an entity since the 4th century BC by Hippocrates. Contemporary medical research since the early 20th century has attempted to clarify the spectrum of the different pathologies that this clinical syndrome represents [1]. Up till now, the pregnancy causes changes in spinal curvature and posture remains open for further studies. One of the most frequent complications of pregnancy is low back pain, with 50±70% prevalence [2]. Its incidence is higher in the third trimester of pregnancy, when the most important biomechanical and morphological changes take place. From the second trimester, abdominal morphology is altered by the increased size of the uterus and the weightiness of the fetus, with a 30% gain in abdominal mass [3]. Despite the frequent occurrence of the problem, no explicit criteria for diagnosis and therapy guidelines are available in the literature. The increased size of the abdomen has been linked to a decreased static stability and adaptive changes in spinal curvatures, which would compensate the anterior displacement of the center of gravity, to ensure postural balance [4]. Postural alterations most frequently mentioned in the literature are increased lumbar curvature, pelvic ante version as illustrated in Figures 1 & 2; [5] increased thoracic curvature [6], increased cervical curvature, protraction of the shoulder girdle, hyper extended knees [7], and extension of the ankles [8] Walking is an essential daily activity and important in controlling adipose tissue weight gain associated with pregnancy [9,10]. The mechanics of walking, however may be affected as pregnancy, are characterized by maternal changes in shape and dimensions, particularly in the trunk. As pregnancy progresses, the lower trunk segment inertial characteristics show a significantly larger rate of increase than any other body segments. With rapid changes in mass, and moment of inertia, [11] trunk segment kinematics may be altered in daily activities such as walking. The possibility of altered kinematics is important as this may also affect the kinetics and hence musculoskeletal demands on the trunk segments [12]. Much of the focus on trunk mechanical adaptations in pregnancy has been on static postures [13]. These adaptive changes include.
Authors and Affiliations
Mohamed Nabih EL Gharib, Amro D Aglan
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