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Maternal musculoligamental conditions 

Maternal musculoligamental conditions
Chapter:
Maternal musculoligamental conditions
Author(s):

Harini Narayan

DOI:
10.1093/med/9780199673643.003.0016
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date: 31 May 2020

Pelvic girdle pain (symphysis pubis dysfunction, SPD) is not a disease, yet often leads to unnecessary in-patient admissions, scans, X-ray exposure, and unwarranted procedures such as early inductions of labour or Caesarean section. The symptoms are caused by softening of the pelvic girdle ligaments, which are permanently stretched as a result of previous pregnancies and further affected by hormonal effects in the current pregnancy. This chapter highlights the need for all healthcare professionals to offer uniform advice. Diagnosis and management of SPD depend on the severity of symptoms, not on X-ray measurement of a ‘symphyseal gap’. Basic physiotherapy referral and strategies are reinforced, as is pain management with simple analgesics. Fibromyalgia syndrome and chronic fatigue syndrome are ill-understood chronic conditions with considerable overlap of clinical features and response to management modalities. No change in obstetric management is required, but supportive management in primary care is important. Patient information is provided.

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