1/11. Treatment of severe low back pain with opioids during pregnancy in a patient with incomplete tetraplegia.We report a case of severe low back pain during pregnancy in a woman with incomplete tetraplegia due to viral myelitis. The pain was interpreted as a radiculopathy in the presence of multiple herniated discs. Surgical intervention was not indicated and physiotherapy failed; therefore, a symptomatic drug treatment with oral analgesics was initiated. To minimise the total daily opioid dosage and the potential risk of a neonatal withdrawal syndrome due to opioids, the route of administration was changed from oral to epidural. Adequate pain relief was maintained with this regimen until caesarean section was necessary. The neonatal withdrawal symptoms after delivery were mild. Residual pain slowly diminished after delivery and the patient was able to discontinue opioid therapy. The aetiology of low back pain remains unclear and may be multifactorial.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
2/11. Postpartal sacral fracture without osteoporosis.Stress fractures of the sacrum during pregnancy or the postpartum seem uncommon. We report a new case of nontrauma-related postpartal sacral fracture. Only four similar cases have been reported to date. The patient was 36 years of age and her fracture was diagnosed four weeks after her first delivery. vitamin d levels were low, but there was no osteomalacia. Other standard laboratory tests were normal, as were absorptiometry measurements at the lumbar spine and femur. Rheumatologists should consider sacral fracture in pregnant or nursing patients with buttock pain. magnetic resonance imaging is the diagnostic investigation of choice.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
3/11. Acute pancreatitis occurring in the early postpartum period: a case report.We report a case of acute pancreatitis, which occurred after delivery in a woman who had an uneventful course of pregnancy and parturition. A 17-year-old Japanese woman was referred to our department because of nausea and vomiting two hours after delivery, followed by severe abdominal and back pain. On admission, in addition to elevated serum and urine amylase, plain computed tomography demonstrated a swollen pancreas and high density in the peripancreatic lesion with a large amount of ascites, suggesting the presence of an inflammation of the pancreas as well as peripancreatic lesion. Accompanied by subsiding abdominal and back pain, serum amylase concentration gradually decreased and returned to a normal level on the 11th postpartum day. Acute pancreatitis must be kept in mind when evaluating patients presenting with abdominal pain after delivery.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
4/11. Spinal subdural empyema: report of two cases.Spinal subdural empyema (SSE) is a rare variety of intraspinal infection. SSE should be suspected in patients presenting with fever, back pain, and signs of cord or nerve root compression. Two patients with SSE are presented. The first patient complained of fever and back pain. She had no neurological deficit but was found to have SSE. The second patient, who presented with intracerebral hemorrhage in the fifth month of pregnancy and spontaneous abortion, was found to have SSE at lumbar puncture. The clinical manifestations and management are discussed.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
5/11. pregnancy-associated osteoporosis manifesting for the first time during second pregnancy.We present here a case of 26-year-old woman with pregnancy-associated severe osteoporosis which occurred for the first time at the end of the second pregnancy. We discuss changes in bone mass and metabolism taking place during normal pregnancy and other possible factors of osteoporosis during that period.- - - - - - - - - - ranking = 1.4keywords = pregnancy (Clic here for more details about this article) |
6/11. Protecting the back during pregnancy.Although pregnancy is a healthy condition, anatomical changes do occur that cause poor alignment and low back pain. A pregnant worker will feel stronger and more comfortable if she maintains her pelvis in a tilted position. The occupational health nurse can instruct the pregnant worker about exercises and proper body mechanics so that she maintains good spine alignment.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
7/11. An unusual case presentation. Cellular schwannoma in pregnancy: an unusual cause of low back pain.A cellular schwannoma is a benign hypercellular variant of a peripheral nerve sheath tumor. It usually arises in the posterior roots of the neck, mediastinum or pelvis. It produces neurologic symptoms by direct pressure on neural elements, local swelling and/or tissue necrosis. In general, the rate of progression of symptoms will determine the need for surgical intervention, which consists of total local excision. We present the first reported case of a cellular schwannoma in pregnancy; the main symptom was intractable low back pain.- - - - - - - - - - ranking = 1keywords = pregnancy (Clic here for more details about this article) |
8/11. spinal cord compression following labor and delivery with epidural analgesia.Transient back pain is not uncommon during pregnancy and the postpartum period. Following an epidural anesthetic, back pain persisted in a postpartum patient beyond the expected period of soreness. Further diagnostic evaluation led to diagnosis and surgical decompression of a herniated thoracic disc.- - - - - - - - - - ranking = 0.2keywords = pregnancy (Clic here for more details about this article) |
9/11. Incidental diagnosis of pregnancy on bone and gallium scintigraphy.Bone and gallium scintigraphy were performed as part of the diagnostic workup of a 21-yr-old woman who presented at our institution with a history of progressively worsening low back pain over a 1-wk period of time. The angiographic phase of the bone scan demonstrated a well-defined radionuclide blush within the pelvis just cephalad to the urinary bladder with persistent hyperemia noted in the blood-pool image. We attribute these findings to a uterine blush secondary to the pronounced uterine muscular hyperplasia, hyperemia, and edema that accompany pregnancy. gallium scintigraphy demonstrated intense bilateral breast accumulation of the imaging agent in a typical doughnut pattern which is commonly found in the prelactating and lactating breast. Also demonstrated was apparent gallium accumulation in the placenta. This case is presented to emphasize the radionuclide findings that occur during pregnancy, particularly the incidental finding of radionuclide blush during the angiographic phase of a radionuclide scintigraphy which should alert the nuclear physician to the possibility of pregnancy in a woman of childbearing age.- - - - - - - - - - ranking = 1.4keywords = pregnancy (Clic here for more details about this article) |
10/11. Low-back pain in pregnancy.Two hundred women were interviewed within 24-36 hours after giving birth. The patients were not examined. It was found that 56% of the patients suffered from low-back pain during pregnancy. The percentage of Caucasians was statistically higher in the back pain group. The percentage of Hispanics was statistically higher in the no pain group. Among the variables that were compared in both groups were the age, the weight gained by the mothers during pregnancy, the baby's weight, the number of previous pregnancies, number of prior children. None of the variables reached a statistically significant level. The pain group complained of pain the low-back area, which radiated in 45.5% of cases to the lower extremities. In about one-third of the patients the pain increased as the day wore on, whereas in another one-third the pain increased during the night and disturbed sleep. Standing, sitting, forward bending, lifting, and walking tended to increase the pain. Most of the patients started suffering from back pain between the fifth and seventh months of pregnancy. Several theories to explain the occurrence of backache during pregnancy are discussed.- - - - - - - - - - ranking = 1.6keywords = pregnancy (Clic here for more details about this article) |
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