OB Patient Flashcards
What % of pregnant woman report low back pain (LBP)?
60%
What are 3 factors that influence Somatic Dysfunction in Pregnancy?
Body Fluid circulation
Hormonal Changes
Changes in structure/biomechanics
What are 3 MSK conditions that change in pregnancy?
- Scoliosis more pain and premature birth
- RA Improved symptoms
- Ankylosing Spondylitis Aggravated by pregnancy
What are 9 symptoms caused by pregnancy?
- Exaggerated Lumbar Lardosis
- Ligament lax
- Anterior Tilt of Pelvis
- Compression structure b/c fluid retained
- Flexion of Neck
- Downward movement of shoulders
- Weak/Seperation of Abdominal M.
- Joint/Laxity of Ant/Post. Longitudinal Ligaments
- Widening/inc. mobility of SI joint/Public symphysis
What are some alarm finding in pregnancy?
-Sever Pain messes with function, especially at night
-Inc. pain w/ cough, sneezing valsalva
-Neuo deficits: Bowel/Bladder dysfunction, failure to urinate,
Abnormal Reflexes, sensory deficits, weakness
What are 3 hemodynamic changes that are INCREASED with pregnancy?
CO
Blood Volume
Plasma Volume
What are 3 hemodynamic changes that are DECREASED with pregnancy?
Systemic Vascular Resistance
Blood Pressure
Hematocrit (dilution effect)
What is a treatement for Hyperemesis gravidarum?
Treat C2 and T5-9
What type of pain my patients describe as “Lightning Pain”?
Radicular pain N. root compression, paraethesia on Ilioinguinal/Genitofemoral N.
Risk Factors for LBP?
- Pain w/ menstration
- Multiparity
- Higher BMI
- Smoking
- Stenuous Work
- Previous LBP in pregnancy
- Preexisting LBP
What % of LBP resolves after pregnancy?
80-95%
What position should you recommend pregnant mother sleep in?
L. Lateral Recumbant; inc. CO
What are 3 causes of decreased lymphatic flow?
Fascial torsions
organ hypertrophy
diaphragm restriction
Most Symptoms appear during what trimester? Symptoms are?
3rd Trimester
Hemmoriods, vulvar and Lower extremities varicosities, inc. venous stasis
What does decreased flow to pelvis cause?
stagnant hypoxia of the neural and vertebral tissues
What hormone is elevated during the 1st trimester?
Relaxin, higher most more likely to have LBP
What does porgesterone do?
Inc. Circumference to thoracic cage 5-7cm
subcostal angles widen 63 to 103
diaphragm pushes superiorly
inc. in tidal volume 30-40%
What are relative contraindiacations with OMT in pregnancy?
PPROM
Premature Labor
What are some examples of Absolute Contraindications of OMT in pregnancy?
Think vaginal Bleeding!
- Placental Abruption or previa
- Threatened/incomplete abortion
- Ectopic pregnancy
- Prolapsed Umbilical cord
What is a symptom in 2nd trimester? (Hint we discussed this in CBL)
- Round ligament Pain
- Carpal Tunnel Syndrome
What position can be done throughout 2nd trimester?
Supine
What should you do 1st visit post pardum?
Screen for SD
trt Prior Sd of ligamental structures
evaluate sacrum cause Anterior Sacral Base
What should you do on the 2nd visit post pardum?
review structural changes
Screen for SD
Assess need for future contraception
Advise follow up care for chronic problems
How much exercise is recommended during pregnancy?
30 minutes or more moderate all/most days
What are some Relative contraindications to aerobic exercise in pregnancy?
IUGR
Unevaluated Maternal Cardiac Arrythmias
Poor controled DM 1
Extremely low Weight
What are some Absolute contraindications to aerobic exercise in pregnancy?
similar to Those do not do OMT on
Bleeding issues
IUGR
