Faculty Bibliography

An attempt was made to determine the effect of pregnancy on the abdominal muscles and to correlate changes in abdominal muscles strength with low-back pain during pregnancy. The study included 328 women. Group A consisted of 164 pregnant women; group B consisted of 164 non-pregnant women. The race, age, height, weight, parity, profession, time devoted to physical fitness per week, abdominal length, and relation between the abdominal length to height were recorded. A detailed history relating to backache prior to and during pregnancy was obtained. Each woman was asked to perform a single sit-up. The results of the study indicate that about 10% of pregnant women develop severe low-back pain that interferes with daily life activities. About 49% of the non-pregnant women complained of LBP. The pain did not interfere with activities of daily living. During pregnancy, due to overstretching of the abdominal muscles, the ability to perform a sit-up is significantly decreased. Whereas all non-pregnant women could perform a sit-up, 16.6% of pregnant women could not perform a single sit-up. There was no statistically significant correlation between the sit-up performance and backache. It may be concluded that during pregnancy the abdominal muscles become insufficient.

One hundred women responded to a questionnaire dealing with night backache during pregnancy. All the women were in the second half of their pregnancy. Sixty seven per cent of the women reported discomfort and/or backache during the night. We hypothesize that hypervolemia combined with obstruction of the inferior vena cava, caused by the enlarging uterus, is the underlying pathomechanism leading to night backache. Patients with inadequate venous collateral circulation may develop excessive pressure within the venous system, the vertebral bodies and overdistension of venous channels distal to the occluded zone. These changes may lead to hypoxemia, metabolic disturbances, irritation of unmyelinated nerves and result in night backache.