Munro Allana, George Ronald B, Chorney Jill, Snelgrove-Clarke Erna, Rosen Natalie O
Department of Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS.
Department of Women's & Obstetric Anesthesia, IWK Health Centre, Halifax, NS; Department of Anesthesia, Pain Management and Perioperative Medicine, Dalhousie University, Halifax, NS.
J Obstet Gynaecol Can. 2017 Sep;39(9):734-741. doi: 10.1016/j.jogc.2017.01.026. Epub 2017 Jun 16.
A clinically relevant number of patients report pain 1 year after vaginal delivery or Caesarean delivery. Study objectives were to identify the incidence of peripartum pain; determine whether pre-existing pain, pregnancy pain, or pain 2 weeks postpartum predicts pain at 3 months; and to identify whether delivery mode, epidural analgesia use, or delivery complications predict non-genito-pelvic pain postpartum.
Primiparous women at 30 to 36 weeks GA with an uncomplicated singleton pregnancy were recruited from a large perinatal clinic. Participants completed questionnaires on sociodemographics and non-genito-pelvic pain. Questionnaires were completed in the perinatal clinic and then electronically 2 weeks and 3 months postpartum.
Of the 133 women included, 50 patients (38%) had a chronic pain condition or pain prior to pregnancy, whereas 73 patients (55%) reported pain in pregnancy. Pain was present 2 weeks postpartum in 57 patients (43%) and 3 months postpartum in 33 patients (25%). Patients with pre-existing pain were more likely to experience pain 2 weeks postpartum (P = 0.006), and patients with pain 2 weeks postpartum were more likely to have pain 3 months postpartum (P = 0.005). Women who had a Caesarean delivery (P < 0.001) were more likely to have non-genito-pelvic pain at 2 weeks but not 3 months postpartum.
Women with pain 2 weeks postpartum were significantly more likely to have pain at 3 months. Further investigation is required to determine whether pre-existing pain, pain in pregnancy, or pain at 2 weeks postpartum can adequately predict the likelihood of chronic pain.
相当数量的患者报告在阴道分娩或剖宫产术后1年仍有疼痛。研究目的是确定围产期疼痛的发生率；确定孕前疼痛、孕期疼痛或产后2周疼痛是否可预测3个月时的疼痛；并确定分娩方式、硬膜外镇痛的使用或分娩并发症是否可预测产后非生殖器盆腔疼痛。
从一家大型围产期诊所招募妊娠30至36周、单胎妊娠且无并发症的初产妇。参与者完成了关于社会人口统计学和非生殖器盆腔疼痛的问卷调查。问卷调查在围产期诊所完成，然后在产后2周和3个月以电子方式完成。
在纳入的133名女性中，50名患者（38%）在怀孕前有慢性疼痛或疼痛，而73名患者（55%）报告在孕期有疼痛。57名患者（43%）在产后2周出现疼痛，33名患者（25%）在产后3个月出现疼痛。孕前有疼痛的患者在产后2周更有可能经历疼痛（P = 0.006），产后2周有疼痛的患者在产后3个月更有可能有疼痛（P = 0.005）。剖宫产的女性在产后2周更有可能有非生殖器盆腔疼痛（P < 0.001），但产后3个月则不然。
产后2周有疼痛的女性在3个月时出现疼痛的可能性显著更高。需要进一步调查以确定孕前疼痛、孕期疼痛或产后2周疼痛是否能够充分预测慢性疼痛的可能性。
