Osteoarthritis is common in pregnant and postpartum women

Pregnancy affects the progression of some arthropathy such as aggravating some diseases, on the other hand relieving some diseases such as rheumatoid arthritis, psoriatic arthritis. Many cases that are not diagnosed and treated properly have adversely affected the health of both mother and child.

Lumbar pain - pelvis

Posture changes related to pregnancy (lumbar spine and neck segment protruding, chest segment and more curving out than before pregnancy) are important causes of pain. back. On the other hand, under the effect of hormones during pregnancy, the joints and soft ligaments and stretches are the pelvic area, pubic joints, joint joints - pelvic and joint amputations make the pelvis easy to change and increase the width to help bring Pregnancy and delivery are easy.

Expression : Nearly half of cases have low back pain during pregnancy especially in the middle 3 months and the last 3 months. Pain is often localized in the lumbar and joint areas of the pelvis, with little or no spread, increased when exercised and palpable on the spot, reduced during rest.

Treatment: Taking anti-pain medication acetaminophen group (paracetamol ) and physical therapy is the first choice.

After birth, especially for large pregnancies, prolonged labor can cause pain in many areas along the pot, unable to walk. More severe, arthritis and infected pelvic (high fever, severe pain, thinning) need to be treated with antibiotics. Note that many antibiotics are not used because milk secretion affects children. The beta lactamine and cephalosporin groups are the antibiotic of choice.

Inflammation of the adenocarcinoma of the tendon into the bone and tendonitis

Pregnant women should regularly sunbathe to increase vitamin D synthesis (Photo: TTO)

With the upper limb in the position of the ribs attached to the bone or inflamed is the pharyngeal strabismus, cylindrical scars, outer protrusions and in the arms. The lower limb is an inflamed spot that adheres to the muscle of the thigh (large shift) and the muscular thigh (small dynamic), Achille tendon in the heel. In which sciatic stenosis (De Quervain syndrome) is more common.

The cause of the disease is due to the sphincter area with a synovial fluid covering the two tendons of the long and short muscles of the thumb. When the capsule is inflamed, it causes pain and restricts the movement of the thumb. This is the most common disease in this period, especially in women who have to work a lot by hand and twist wrist movements (washing, spinning clothes .).

Manifestations : The patient sees swelling and pain on the outer edge of the rotating bone tip, increased pain when using the thumb and constant pain especially at night. The examination may find this area slightly swollen, pressing on the pain. When doing some movements, the pain increases: the patient stretches and the form of the thumb that the doctor opposes, or tells the patient to put the thumb into the root of the little finger, we push the hand to close as much as possible. causing a stinging sensation.

For prevention, avoid excessive wrist and finger twisting movements as mentioned above. Anti-pain medications for acetaminophen and physiotherapy (infrared) are effective in some cases. If not supported, see a specialist for specific treatment.

Tendani due to hypocalcaemia

During pregnancy and lactation, large amounts of calcium are taken from the mother to the fetus to develop the fetal bone system. This process causes the mother's blood calcium levels to decrease, especially in mothers who have an inadequate dietary calcium requirement (1,500 mg / day) or those with chronic gastrointestinal disease which reduces steaming. intestinal calcium. People who suffer from morning sickness are as much vomiting as dehydration, electrolytes and alkalosis accompanied by anxiety, enabling the tétani to appear.

Symptoms : Tétani is an excessive stimulation of the nervous system - muscle, warning or accompanying is a paresthesia, severe in the arms, legs, and perioral area. Next is the sudden contraction of the muscle, especially in the hands and fingers that create the image like the hand of the deliverer. Muscular contractions may occur in other locations such as the legs or face. Some cases are accompanied by smooth muscle spasms, which can cause shortness of breath due to tracheal spasms or abdominal pain due to smooth muscle contractions in the intestine . The condition of muscle contraction lasts from a few minutes to several hours. There may be anxiety, panic, rapid pulse . The intermittent exam can detect the condition of cheek muscles when typing with a hammer in the ear area (Chvostek sign) or bout Tétani reappears when it requires patients to breathe quickly (causing blood alkalosis due to hyperventilation). Blood tests in the attack will see blood calcium decrease but sometimes there are cases where blood calcium is not reduced.

Prevention and treatment: Calcium (1,000-1,500 mg / day) and vitamin D must be supplemented with calcium-rich foods (crabs, fish, meat .), sun exposure to increase vitamin D synthesis from the skin. The symptoms of the rupture will go away quickly if an intravenous solution of calcium is administered (usually using 500-1,000mg of calcium chloride solution ).

To maintain good health for both mother and child, pregnant women should not arbitrarily use drugs to treat osteoarthritis during pregnancy and lactation. When taking the drug, you must have the advice of a specialist to avoid unwanted consequences for both mother and child.

According to Dr. DAO HUNG HANH (Bach Mai Hospital)