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The Prognostic Value of Asymmetric Laxity of the Sacroiliac Joints in Pregnancy-Related Pelvic Pain

Damen, Léonie MSc*†; Buyruk, H. Muzaffer PhD*; Güler-Uysal, Füsun PhD§; Lotgering, Frederik K. PhD‡; Snijders, Chris J. PhD†; Stam, Hendrik J. PhD*

Diagnostics

Study Design. Prospective cohort study.

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

Summary of Background Data. 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 ≥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.

Conclusion. 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.

From the *Institute of Rehabilitation Medicine,

†Department of Biomedical Physics and Technology,

and ‡Department of Obstetrics and Gynecology, Erasmus University Rotterdam, Rotterdam, The Netherlands,

and the §Department of Physical Medicine and Rehabilitation, Çukurova University, Faculty of Medicine, Adana, Turkey.

Supported by the Algesiologic Institute, Rotterdam, The Netherlands.

Acknowledgment date: January 31, 2002.

First revision date: April 29, 2002.

Acceptance date: May 6, 2002.

The manuscript submitted does not contain information about medical device(s)/drug(s).

Institutional funds were received to support this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence to Léonie Damen, MSc, Erasmus University Rotterdam, Institute of Rehabilitation Medicine, Dr. Molewaterplein 40, 3015 GD Rotterdam, The Netherlands; E-mail: leoniedamen@ hotmail.com

© 2002 Lippincott Williams & Wilkins, Inc.