Pelvic Girdle Pain Survey in Pregnancy: A Maternity Hospital Experience

O. Oduola, T. McDonagh, M. O’Leary

Department of Obstetrics and Gynaecology, Galway University Hospital



Sir,

The demand to see a physiotherapist is of crucial importance in pregnancy. Evidence has shown that a rising level of relaxin, progesterone and estrogen increase joint laxity in pregnancy resulting in Pelvic Girdle Pain (PGP)1. Studies suggest that pregnancy causes an irreversible widening and relaxation of the pelvis that result in instability and laxity of the joint(s)2. Physiotherapists have been overwhelmed with multiple referrals for management of PGP which clinicians can manage. Back pain prior to pregnancy also worsens the risk of PGP.

However, there are long waiting times to visit a physiotherapist in the public clinic, frustrating patients and their obstetricians. We therefore carried out a study in the Galway University Hospital to see if the patients are being triaged properly before referring them to the physiotherapy department, by using a pain score questionnaire.

We administered an anonymous questionnaire to all our antenatal patients within a two-week period, looking at age, gestation and their subjective pain score. We used the national guideline of Pelvic Girdle Pain score questionnaire3 and adapted it for our study. We included all the women attending the maternity department from August 15th-26th 2017, while excluding any patients attending the physiotherapy department or postnatal ward and those with incomplete forms.

177 patients responded to our questionnaire, 5 patients were excluded based on incompletely filled surveys. The reported range for age, gestation and parity in our sample population were 21-45, 6-41 and 0-14 respectively. Fifty-three (31%) of the patients were referred to the physiotherapists; seven (13%) were asymptomatic, 20 (38%) minimal, 15 (28%) moderate, 10 (19%) severe and 1 (2%) crippled PGP scores. However, 119 (69%) patients were not referred and in this group 58 (49%) of the patients recorded a minimal pain score.

Our findings suggest that the pain score questionnaire could be used as a screening tool before patient are referred to the physiotherapist, to help reduce the waiting time and to ensure that the right patients are getting the proper management on time.

Correspondence:
O.Oduola,
Department of Obstetrics and Gynaecology,
Galway University hospital.
Email: Oladayoo@gmail.com


References

1. Casagrande D, Gugala Z, Clark SM, Lindsey RW. Low Back Pain and Pelvic Girdle Pain in Pregnancy. Journal of the American Academy of Orthopaedic Surgeons. 2015;23(9):539–49. 
2. Wu WH, Meijer OG, Uegaki K, Mens JMA, Dieën JHV, Wuisman P I J M Wuisman and H. C Ostgaard. Pregnancy-related pelvic girdle pain (PPP), I: Terminology, clinical presentation, and prevalence. European Spine Journal. 2004;13(7):575–89.
3. Management of Pelvic Girdle Pain in Pregnancy and Post-partum [Internet]. Scribd. Scribd; [cited 2018Mar19]. Available from: https://www.scribd.com/document/120156048/Management-of-Pelvic-Girdle-Pain-in-Pregnancy-and-Post-partum

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