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Bekkenleddsmerter

Sist revidert:
Sist revidert av:

Definisjon:
Smerter fra iliosakralleddene (IS-ledd) og/eller symfysen som oppstår under svangerskap eller rett etter fødsel
Forekomst:
15% av gravide oppgir å ha bekkenleddsmerter i siste del av svangerskapet
Symptomer:
Smerter over IS-ledd og/eller symfyse ved belastning, gange, stillingsendringer. Debuterer ofte i 1. trimester
Funn:
Ofte haltende, forsiktig gange. Trykkømhet over symfyse og IS-ledd
Diagnostikk:
Kliniske tester som kan verifisere smerter relatert til bekkenleddene. Bildediagnostikk er vanligvis ikke påkrevd
Behandling:
Gode hvilestillinger, fysisk aktivitet som ikke forverrer leddsmertene, individualisert fysioterapi. Etter fødsel har et individualisert behandlingsopplegg med fokus på spesifikke øvelser effekt
  1. Norsk Gynekologisk Forening. Veileder i fødselshjelp. Oslo; 2020: siden besøkt 08.06.2022 www.legeforeningen.no  
  2. Stuge B. Diagnostikk og behandling av bekkenleddsplager. Tidsskr Nor Legeforen 2010; 130: 2141-5. doi:10.4045/tidsskr.09.0702 DOI  
  3. Bjelland EK, Eskild A, Johansen R, Eberhard-Gran M. Pelvic girdle pain in pregnancy: the impact of parity. Am J Obstet Gynecol 2010; 203: 146. PubMed  
  4. Vleeming a, Albert HB, Östgaard HC, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J 2008; 17: 794-819. PubMed  
  5. Bjelland EK, Stuge B, Engdahl B, et al. The effect of emotional distress on persistent pelvic girdle pain after delivery: a longitudinal population study. BJOG 2013; 120: 32-40. doi:10.1111/1471-0528.12029 DOI  
  6. Palsson TS, Graven-Nielsen T. Experimental pelvic pain facilitates pain provocation tests and causes regional hyperalgesia. Pain 2012;153:2233-40. doi: 10.1016/j.pain.2012.07.013 DOI  
  7. Bjelland EK, Eberhard-Gran M, Nielsen CS, Eskild A. Age at menarche and pelvic girdle pain in pregnancy. Conference abstract. NGF Årsmøte, 2010.
  8. Owe KM, Bjelland EK, Stuge B, et al. Exercise level before pregnancy and engaging in high-impact sports reduce the risk of pelvic girdle pain: a population-based cohort study of 39 184 women. Br J Sports Med 2015. doi:10.1136/bjsports-2015-094921 DOI  
  9. Bjelland E, Owe K, Stuge B, et al. Breastfeeding and pelvic girdle pain: a follow-up study of 10 603 women 18 months after delivery. BJOG 2014. doi: 10.1111/1471-0528.13118 DOI  
  10. Champaneria R, Shah L, Moss J, et al. The relationship between pelvic vein incompetence and chronic pelvic pain in women: systematic reviews of diagnosis and treatment effectiveness. Health Technol Assess 2016; 20: 1-108. doi:10.3310/hta20050 DOI  
  11. Persson M, Winkvist A, Dahlgren L, Mogren I. “Struggling with daily life and enduring pain”: a qualitative study of the experiences of pregnant women living with pelvic girdle pain. BMC Pregnancy and Childbirth 2013. doi:10.1186/1471-2393-13-111 DOI  
  12. Malmqvist S, Kjaermann I, Andersen K et al. Can a bothersome course of pelvic pain from mid-pregnancy to birth be predicted? A Norwegian prospective longitudinal SMS-Track study. BMJ Open. 2018 Jul 25;8(7):e021378. PMID: 30049694 PubMed  
  13. Stafne SN, Salvesen KA, Romundstad PR et al. Does regular exercise during pregnancy influence lumbopelvic pain? A randomized controlled trial. Acta Obstet Gynecol Scand 2012;91:552-9. doi: 10.1111/j.1600-0412.2012.01382.x DOI  
  14. Davenport MH, Marchand AA, Mottola MF et al. Exercise for the prevention and treatment of low back, pelvic girdle and lumbopelvic pain during pregnancy: a systematic review and meta-analysis. Br J Sports Med. 2019 Jan;53(2):90-98. Epub 2018 Oct 18. PMID: 30337344 PubMed  
  15. Stuge B. Current Knowledge on Low Back Pain and Pelvic Girdle Pain During Pregnancy and after Childbirth: A Narrative Review. Current Women's Health Rev 2015; 11: 68-74. doi:10.2174/157340481101150914201838 DOI  
  16. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database of Systematic Reviews 2015, Issue 9. Art. No.: CD001139. DOI: 10.1002/14651858.CD001139.pub4. DOI  
  17. Stuge B, Laerum E, Kirkesola G, Vøllestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a randomized controlled trial. Spine (Phila Pa 1976) 2004; 29: 351-9. pmid:15094530 PubMed  
  18. Javadov A, Ketenci A, Aksoy C. The Efficiency of Manual Therapy and Sacroiliac and Lumbar Exercises in Patients with Sacroiliac Joint Dysfunction Syndrome. Pain Physician. 2021 May;24(3):223-233. PMID: 33988941. PubMed  
  19. Gutke A, Betten C, Degerskär K, et al. Treatments for pregnancy-related lumbopelvic pain: a systematic review of physiotherapy modalities. Acta Obst Gyn Scand 2015; 94: 1156-67. doi:10.1111/aogs.12681 DOI  
  20. Elden H, Ladfors L, Olsen MF, Ostgaard HC, Hagberg H. Effects of acupuncture and stabilizing exercises as adjunct to standard treatment in pregnant women with pelvic girdle pain: randomised single blind controlled trial. BMJ 2005; 330: 761. British Medical Journal  
  21. Quintero Rodriguez C, Troynikov O. The Effect of Maternity Support Garments on Alleviation of Pains and Discomforts during Pregnancy: A Systematic Review. J Pregnancy. 2019 Aug 1;2019:2163790. PMID: 31467715 PubMed  
  22. Bjelland EK, Stuge B, Vangen S, et al. Mode of delivery and persistence of pelvic girdle syndrome 6 months postpartum. Am J Obstet Gynecol 2013; 208: 298.e1-7. doi:10.1016/j.ajog.2012.12.002 DOI  
  23. van Benten E, Pool J, Mens J, Pool-Goudzwaard A. Recommendations for physical therapists on the treatment of lumbopelvic pain during pregnancy: a systematic review. J Orthop Sports Phys Ther 2014; 44: 464-73. doi:10.2519/jospt.2014.5098 DOI  
  24. Larsen EC, Wilken-Jensen C, Hansen A, Jensen DV, et al. Graviditetsrelaterede bækkensmerter. Ugeskr Læger 2000; 162: 4808-12. PubMed  
  25. Robinson HS, Eskild A, Heiberg E, Eberhard-Gran M. Pelvic girdle pain in pregnancy: The impact on function. Acta Obstetr Gynecol Scand 2006; 85: 160-4. PubMed  
  • Britt Stuge, PhD, fysioterapeut spesialist i kvinnehelse MNFF, forskningsleder i fysioterapi, Ortopedisk klinikk, Oslo Universitetssykehus

Tidligere fagmedarbeidere

  • Trine Hessevik Paulsen, allmennlege og redaksjonsmedarbeider i NEL