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OSIV > 13. Osteopathic Approach to the OB Patient > Flashcards

13. Osteopathic Approach to the OB Patient Flashcards

1
Q

How does scoliosis change during pregnancy?

A

May develop more pain

-possible increase risk of premature birth

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2
Q

How does rheumatoid arthritis pain change during pregnancy?

A

Actually gets better

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3
Q

How is ankylosing spondylitis changed during pregnancy?

A

Aggravated by pregnancy

-due to stress on SI joints

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4
Q

What’s the number one complaint of pregnant women?

A

Low back pain

Increase:
Anterior Tilt
Lordosis
Increase kyphosis

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5
Q

How does an increase in lordosis of lumbar spine cause pain?

A

Increase stress across the vertebral facets and increased shear forces across IV discs

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6
Q

What causes the mechanical back pain seen in pregnancy? (3)

A

Postural changes
Muscle weakness

Excessive connective stretching
-SI region

Poster pelvic pain

  • distal and lateral to lumbosacral junction
  • radiates down posterior thigh to knee
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7
Q

What are some red flag warnings in pregnant patients with low back pain that warrant some additional evaluation?

A
  • severe pain interferes with function
  • increase pain w cough, sneeze, valsalva
  • Neuro deficits
  • -bladder and bowel issues, weakness, sensory deficits
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8
Q

Which cause of back pain follows a nerve pattern and is due to herniated/bulging disc?

A

Radicular pain

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9
Q

Which cause of back pain presents as lightning pains and paresthesias in ilioinguinal and genitofemoral nerve distribution?

A

Peripheral n compression

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10
Q

What are some risk factors for LBP during pregnancy?

A

Multiparity
High BMI
Smoking
Age

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11
Q

Why does lymphatic stress increase during pregnancy?

A

Increase in fluid to support the fetus

Estrogen, progesterone, and adrenal hormones promote fluid retention

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12
Q

How does said fluid build up during pregnancy cause pain?

A

Decreased lymphatic flow results in:

  • fascial torsions
  • organ hypertrophy
  • diaphragm restriction
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13
Q

Which way should women lie during pregnancy?

A

Left lateral recumbent increase CO in moms

-supine allows infant puts stress on IVE

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14
Q

What causes the low back pain seen with venous stresses?

A

Decreased flow in pelvis results in stagnant hypoxia of the neural and vertebral tissues=Back pain

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15
Q

What hormone is associated with some of the back pain seen during pregnancy? (2)

A

Relaxin
-causes joint laxity, especially in SI joints where a lot of pregnant women have pain

Progesterone
-causes fluid build-up=decreased oxygen and increased waste

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16
Q

Indications for OMM in a pregnant patients?

A

SD
Scoliosis
Edema or congestion

17
Q

Relative contraindications in pregnant patient?

A

Premature rupture of membranes

Premature labor

18
Q

Absolute contraindications in pregnant patient?

A

Undiagnosed vaginal bleeding
Placental previa/abruption
Ectopic pregnancy
Threatened abortion

Etc.. anything that can cause the fetus to abort/maternal harm

19
Q

What biomechanical treatments can you do for pregnant patients?

A

Less forceful stuff: Soft tissue, mfr, stills, fpr, blt to:

  • Junctions of body: C, T, L
  • Sacrum, innominates
20
Q

What lymphatic treatments should you do during pregnancy?

A

Fascial diaphragms
-inlet, resp, pelvic

NOT PEDAL PUMP

21
Q

What neurologic treatments could you do for pregnant patient?

A

Seated paraspinal inhibition to decrease sympathetics

Dr Z said rib raising, but I’m pretty sure that increases?

22
Q

What areas of the body can you treat to increase estrogen, decrease Sym, and increase PSym?

A

T10-L2 inhibition to decrease pelvic organ vasoconstriction, and increase Sym

S2-S4: pelvic organ dilation

23
Q

What treatment should you avoid in third trimester?

A

CV4

-can provoke uterine contractions

24
Q

What is the best way to approach somatic dysfunction after the mom has given birth?

A

Jump on them early

-treating dysfunction prior to resolution of hormonal changes on ligamentous structures (before 6 weeks)

25
Q

What are the relative contraindications for exercise during pregnancy? (2)

A

Intrauterine growth restriction

Unevaluated maternal cardiac arrhythmia

26
Q

What are the absolute contraindications to aerobic exercise during pregnancy?

A 
Incompetent cervix
Multiple gestations
Growth restriction of infant
Persistent second or third trimester bleeding
Placenta previa/abruption
Preeclampsia

OSIV (15 decks)

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