Document Detail


Reflex sympathetic dystrophy in pregnancy: nine cases and a review of the literature.
MedLine Citation:
PMID:  10471143     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To better understand the diagnosis of reflex sympathetic dystrophy of the lower extremities in pregnant women. SUBJECT: Disease analysis using a retrospective series of nine cases and a review of the literature (57 patients and 159 sites of reflex sympathetic dystrophy). RESULTS: This disorder should be considered in any painful pelvic girdle syndrome or lower extremity pain. The hip is involved in 88% of cases. Symptoms develop in the third trimester of pregnancy, between the 26th and the 34th weeks. Magnetic resonance imaging (MRI) provides an early, accurate, and very specific diagnosis, although standard radiography continues to be the first-line diagnostic tool. Fracture occurs in 19% of patients. The etiology and pathophysiology remain unclear, although pregnancy itself appears to play a significant role in this disease. Although locoregional mechanical factors partly explain reflex sympathetic dystrophy. Hypertriglyceridemia appears to be a risk factor. This disorder develops independently, but the conclusion of pregnancy appears to be necessary for cure. Reflex sympathetic dystrophy does not appear to affect the course of the pregnancy. Indications for cesarean delivery remain obstetrical and should be discussed when a fracture is involved. Simple therapeutic management using gentle physical therapy provides rapid and complete recovery in 2-3 months. CONCLUSION: Reflex sympathetic dystrophy during pregnancy remains poorly understood and underestimated. Only joints of the inferior limbs are involved. MRI appears to be the best diagnostic tool. Pathogenesis remains unclear. Fractures are not rare. Treatment should be non-aggressive.
Authors:
C Poncelet; M Perdu; F Levy-Weil; H J Philippe; I Nisand
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  European journal of obstetrics, gynecology, and reproductive biology     Volume:  86     ISSN:  0301-2115     ISO Abbreviation:  Eur. J. Obstet. Gynecol. Reprod. Biol.     Publication Date:  1999 Sep 
Date Detail:
Created Date:  1999-10-06     Completed Date:  1999-10-06     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0375672     Medline TA:  Eur J Obstet Gynecol Reprod Biol     Country:  IRELAND    
Other Details:
Languages:  eng     Pagination:  55-63     Citation Subset:  IM    
Affiliation:
Maternity Ward, Poissy Hospital Center, France. nathalie.bridou@bch.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Female
Gestational Age
Hip Joint
Humans
Knee Joint
Magnetic Resonance Imaging
Pain
Pregnancy
Pregnancy Complications / diagnosis*
Reflex Sympathetic Dystrophy / diagnosis*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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