Chronic pain during pregnancy: a review of the literature

Shona L Ray-Griffith, Michael P Wendel, Zachary N Stowe, Everett F Magann, Shona L Ray-Griffith, Michael P Wendel, Zachary N Stowe, Everett F Magann

Abstract

Background and purpose: The majority of the reviews and studies on chronic pain in pregnancy have primarily focused on the pharmacological and non-pharmacological treatment options. The purpose of our review was to identify evidence-based clinical research for the evaluation and management of preexisting chronic pain in pregnancy, chronic pain associated with pregnancy, and chronic pain in relation to mode of delivery.

Methods: A literature search was undertaken using the search engines PubMed, CINAHL, EBSCOhost, and Web of Science. Search terms used included "chronic pain" AND "pregnant OR pregnancy" OR "pregnancy complications" from inception through August 2016.

Results: The basis of this review was the 144 articles that met inclusion criteria for this review. Based on our review of the current literature, we recommend 7 guidelines for chronic pain management during and after pregnancy: 1) complete history and physical examination; 2) monitor patients for alcohol, nicotine, and substance use; 3) collaborate with patient to set treatment goals; 4) develop a management plan; 5) for opioids, use lowest effective dose; 6) formulate a pain management plan for labor and delivery; and 7) discuss reproductive health with women with chronic pain.

Conclusion: The management of chronic pain associated with pregnancy is understudied. Obstetrical providers primarily manage chronic pain during pregnancy. Some general guidelines are provided for those health care providers until more information is available.

Keywords: chronic pain; chronic pain in pregnancy; guidelines for pain in pregnancy; pain management in pregnancy; pregnancy; pregnancy complications.

Figures

Figure 1
Figure 1
Preexisting chronic pain disorder during pregnancy.

References

    1. What is chronic pain and what are the symptoms? [Accessed July 27, 2016]. Available from: .
    1. Cogan R, Spinnato JA. Pain and discomfort thresholds in late pregnancy. Pain. 1986;27(1):63–68.
    1. Gintzler AR. Endorphin-mediated increases in pain threshold during pregnancy. Science. 1980;210(4466):193–195.
    1. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY, editors. Williams Obstetrics. 23rd ed. New York: McGraw Medical; 2010.
    1. Dørheim SK, Bjorvatn B, Eberhard-Gran M. Insomnia and depressive symptoms in late pregnancy: a population-based study. Behav Sleep Med. 2012;10(3):152–166.
    1. Dørheim SK, Bjorvatn B, Eberhard-Gran M. Sick leave during pregnancy: a longitudinal study of rates and risk factors in a Norwegian population. BJOG. 2013;120(5):521–530.
    1. Babb M, Koren G, Einarson A. Treating pain during pregnancy. Can Fam Physician. 2010;56(1):25–27.
    1. Coluzzi F, Valensise H, Sacco M, Allegri M. Chronic pain management in pregnancy and lactation. Minerva Anestesiol. 2014;80(2):211–224.
    1. Jones HE, Friedman CJ, Starer JJ, Terplan M, Gitlow S. Opioid use during pregnancy: an international roadmap for future research and clinical practice. Addict Disord Their Treat. 2014;13(1):8–15.
    1. Lalkhen A, Grady K. Non-obstetric pain in pregnancy. Rev Pain. 2008;1(2):10–14.
    1. Pritham UA, McKay L. Safe management of chronic pain in pregnancy in an era of opioid misuse and abuse. J Obstet Gynecol Neonatal Nurs. 2014;43(5):554–567.
    1. Wunsch MJ, Stanard V, Schnoll SH. Treatment of pain in pregnancy. Clin J Pain. 2003;19(3):148–155.
    1. Rathmell JP, Viscomi CM, Ashburn MA. Management of nonobstetric pain during pregnancy and lactation. Anesth Analg. 1997;85(5):1074–1087.
    1. Epstein RA, Bobo WV, Martin PR, et al. Increasing pregnancy-related use of prescribed opioid analgesics. Ann Epidemiol. 2013;23(8):498–503.
    1. Naik RP, Lanzkron S. Baby on board: what you need to know about pregnancy in the hemoglobinopathies. Hematology Am Soc Hematol Educ Program. 2012;2012:208–214.
    1. Pryor JR, Maalouf FI, Krans EE, Schumacher RE, Cooper WO, Patrick SW. The opioid epidemic and neonatal abstinence syndrome in the USA: a review of the continuum of care. Arch Dis Child Fetal Neonatal Ed. 2017;102(2):F183–F187.
    1. Kahan M, Wilson L, Mailis-Gagnon A, Srivastava A, National Opioid Use Guideline Group Canadian guidelines for safe and effective use of opioids for chronic noncancer pain: clinical summary for family physicians. Part 2: special populations. Canadian Family Physician. 2011;57(11):1269–1276.
    1. Broussard CS, Rasmussen SA, Reefhuis J, et al. National Birth Defects Prevention Study Maternal treatment with opioid analgesics and risk for birth defects. Am J Obstet Gynecol. 2011;204(4):314.e1–314.e11.
    1. Hardt N, Wong TD, Burt MJ, Harrison R, Winter W, Roth J. Prevalence of prescription and illicit drugs in pregnancy-associated non-natural deaths of Florida mothers, 1999–2005. J Forensic Sci. 2013;58(6):1536–1541.
    1. Yazdy MM, Mitchell AA, Tinker SC, Parker SE, Werler MM. Periconceptional use of opioids and the risk of neural tube defects. Obstet Gynecol. 2013;122(4):838–844.
    1. Taylor JL, McKibben RA, DeCamp M, Chisolm MS. Putting a face on the prescription opioid epidemic: a case report. Gen Hosp Psychiatry. 2014;36(4):449.e1–449.e2.
    1. Nezvalová-Henriksen K, Spigset O, Nordeng H. Effects of codeine on pregnancy outcome: results from a large population-based cohort study. Eur J Clin Pharmacol. 2011;67(12):1253–1261.
    1. Koren G, Cairns J, Chitayat D, Gaedigk A, Leeder SJ. Pharmacogenetics of morphine poisoning in a breastfed neonate of a codeine-prescribed mother. Lancet. 2006;368(9536):704.
    1. Sharpe C, Kuschel C. Outcomes of infants born to mothers receiving methadone for pain management in pregnancy. Arch Dis Child Fetal Neonatal Ed. 2004;89(1):F33–F36.
    1. Kellogg A, Rose CH, Harms RH, Watson WJ. Current trends in narcotic use in pregnancy and neonatal outcomes. Am J Obstet Gynecol. 2011;204(3):259.e1–259.e4.
    1. Bauer AZ, Kriebel D. Prenatal and perinatal analgesic exposure and autism: an ecological link. Environ Health. 2013;12:41.
    1. Becker KG, Schultz ST. Similarities in features of autism and asthma and a possible link to acetaminophen use. Med Hypotheses. 2010;74(1):7–11.
    1. Liew Z, Ritz B, Rebordosa C, Lee PC, Olsen J. Acetaminophen use during pregnancy, behavioral problems, and hyperkinetic disorders. JAMA Pediatr. 2014;168(4):313–320.
    1. Stergiakouli E, Thapar A, Smith GD. Association of acetaminophen use during pregnancy with behavioral problems in childhood: evidence against confounding. JAMA Pediatr. 2016;170(10):964–970.
    1. Thompson JM, Waldie KE, Wall CR, Murphy R, Mitchell EA, ABC Study Group Associations between acetaminophen use during pregnancy and ADHD symptoms measured at ages 7 and 11 years PLoS One 20149(9)e108210.
    1. Das B, McCrory C. Spinal cord stimulation in pregnancy with failed back surgery syndrome. Ir Med J. 2014;107(4):117–118.
    1. Ahmed S, Lindsay JM, Snyder DI. Spinal cord stimulation for complex regional pain syndrome: a case study of a pregnant female. Pain Physician. 2016;19(3):E487–E493.
    1. Bernardini DJ, Pratt SD, Takoudes TC, Simopoulos TT. Spinal cord stimulation and the pregnant patient-specific considerations for management: a case series and review of the literature. Neuromodulation. 2010;13(4):270–274.
    1. Edelbroek C, Terheggen M. High-frequency spinal cord stimulation and pregnancy: a case report. Neuromodulation. 2015;18(8):757–758.
    1. Ito S, Sugiura T, Azami T, Sasano H, Sobue K. Spinal cord stimulation for a women with complex regional pain syndrome who wished to get pregnant. J Anesth. 2013;27:124–127.
    1. Fedoroff IC, Blackwell E, Maylsh L, McDonald WN, Boyd M. Spinal cord stimulation in pregnancy: a literature review. Neuromodulation. 2012;15(6):537–541.
    1. Segal R. Spinal cord stimulation, conception, pregnancy, and labor: case study in a complex regional pain syndrome patient. Neuromodulation. 1999;2(1):41–45.
    1. Saxena A, Eljamel MS. Spinal cord stimulation in the first two trimesters of pregnancy: case report and review of the literature. Neuromodulation. 2009;12(4):281–283.
    1. Yoo HS, Nahm FS, Yim KH, Moon JY, Kim YS, Lee PB. Pregnancy in women with spinal cord stimulator for complex regional pain syndrome: a case report and review of the literature. Korean J Pain. 2010;23(4):266–269.
    1. Sommerfield D, Hu P, O’Keeffe D, McKeating AK. Caesarean section in a parturient with a spinal cord stimulator. Int J Obstet Anesth. 2010;19(1):114–117.
    1. Young AC, Lubenow TR, Buvanendran A. The parturient with implanted spinal cord stimulator: management and review of the literature. Reg Anesth Pain Med. 2015;40(3):276–283.
    1. Ali Sakr Esa W, Toma I, Tetzlaff JE, Barsoum S. Epidural analgesia in labor for a woman with an intrathecal baclofen pump. Int J Obstet Anesth. 2009;18(1):64–66.
    1. Badve M, Shah T, Jones-Ivy S, Vallejo MC. Ultrasound guided epidural analgesia for labor in a patient with an intrathecal baclofen pump. Int J Obstet Anesth. 2011;20(4):370–372.
    1. Tarshis J, Zuckerman JE, Katz NP, Segal S, Mushlin PS. Labour pain management in a parturient with an implanted intrathecal pump. Can J Anaesth. 1997;44(12):1278–1281.
    1. Jones I, Johnson MI. Transcutaneous electrical nerve stimulation. Continuing education in anaesthesia. Crucial Care Pain. 2009;9(4):130–138.
    1. Byrd LM, Jadoon B, Liberman I, Johnston T. Chronic pain and obstetric management of a patient with tuberous sclerosis. Pain Med. 2007;8(2):199–203.
    1. Mulak A, Tache Y, Larauche M. Sex hormones in the modulation of irritable bowel syndrome. World J Gastroenterol. 2014;20(10):2433–2448.
    1. Trikha A, Baidya DK, Singh PM. Complex regional pain syndrome and pregnancy. J Obstet Anaesth Crit Care. 2012;2:69–73.
    1. Sivashanker K, Mufson M, Mittal L, Ross E, Suzuki J. Challenges in managing acute on chronic pain in a pregnant woman at high risk for opioid use disorder in the general hospital setting. Harv Rev Psychiatry. 2015;23(2):157–166.
    1. Somerville BW. A study of migraine in pregnancy. Neurology. 1972;22:824–828.
    1. Wood ME, Frazier JA, Nordeng HM, Lapane KL. Prenatal triptan exposure and parent-reported early childhood neurodevelopmental outcomes: an application of propensity score calibration to adjust for unmeasured confounding by migraine severity. Pharmacoepidemiol Drug Saf. 2016;25(5):493–502.
    1. Callaghan N. The migraine syndrome in pregnancy. Neurology. 1968;18:197–201.
    1. Scharff L, Marcus DA, Turk DC. Headache during pregnancy and in the postpartum: a prospective study. Headache. 1997;37(4):203–210.
    1. Granella F, Sances G, Zanferrari C, Costa A, Martignoni E, Manzoni GC. Migraine without aura and reproductive life events: a clinical epidemiology study in 1300 women. Headaches. 1993;33(7):385–389.
    1. Marozio L, Facchinetti F, Allais G, et al. Headache and adverse pregnancy outcomes: a prospective study. Eur J Obstet Gynecol Reprod Biol. 2012;161(2):140–143.
    1. Facchinetti F, Allais G, Nappi RE, et al. Migraine is a risk factor for hypertensive disorders in pregnancy: a prospective cohort study. Cephalagia. 2008;29:286–291.
    1. Amundsen S, Nordeng H, Nezvalova-Henriksen K, Stovner LJ, Spigset O. Pharmacological treatment of migraine during pregnancy and breastfeeding. Nat Rev Neurol. 2015;11(4):209–215.
    1. Duong S, Bozzo P, Nordeng H, Einarson A. Safety of triptans for migraine headache during pregnancy and breastfeeding. Can Fam Physician. 2010;56(6):537–539.
    1. MacGregor EA. Headache in pregnancy. Neurol Clin. 2012;30(3):835–866.
    1. Jürgens TP, Schaefer C, May A. Treatment of cluster headache in pregnancy and lactation. Cephalalgia. 2009;29(4):391–400.
    1. Marcus DA, Scharff L, Turk DC. Nonpharmacological management of headaches during pregnancy. Psychosom Med. 1995;57(6):527–535.
    1. Nezvalova-Henriksen K, Spigset O, Nordeng H. Triptan exposure during pregnancy and the risk of major congenital malformations and adverse pregnancy outcomes: results from the Norwegian Mother and Child Cohort Study. Headache. 2010;50:563–575.
    1. Kallen B, Lygner PE. Delivery outcome in women who used drugs for migraine during pregnancy with special reference to sumatriptan. Headache. 2001;41:351–356.
    1. Olesen C, Steffensen FH, Sorensen HT, Nielsen GL, Olsen J. Pregnancy outcome following prescription for sumatriptan. Headache. 2000;40:20–24.
    1. Wood ME, Lapane K, Frazier JA, Ystrom E, Mick EO, Nordeng H. Prenatal triptan exposure and internalising and externalising behaviour problems in 3-year-old children: results from the Norwegian Mother and Child Cohort Study. Paediatr Perinat Epidemiol. 2016;30(2):190–200.
    1. Marmura MJ. Use of dopamine antagonists in treatment of migraine. Curr Treat Options Neurol. 2012;14(1):27–35.
    1. Patil S, Willett O, Thompkins T, et al. Botulinum toxin: pharmacology and therapeutics roles in pain states. Curr Pain Headache Rep. 2016;20(3):15.
    1. Barrett JH, Brennan P, Fiddler M, Silman AJ. Does rheumatoid arthritis remit during pregnancy and relapse postpartum? Results from a nationwide study in the United Kingdom performed prospectively from late pregnancy. Arthritis Rheum. 1999;42(6):1219–1227.
    1. de Man YA, Dolhain RJ, van de Geijn FE, Willemsen SP, Hazes JM. Disease activity of rheumatoid arthritis during pregnancy: results from a nationwide prospective study. Arthritis Rheum. 2008;59(9):1241–1248.
    1. Krause ML, Makol A. Management of rheumatoid arthritis during pregnancy: challenges and solutions. Open Access Rheumatol. 2016;8:23–36.
    1. Makol A, Wright K, Amin S. Rheumatoid arthritis and pregnancy: safety considerations in pharmacological management. Drugs. 2011;71(15):1973–1987.
    1. Østensen M, Förger F. Management of RA medications in pregnant patients. Nat Rev Rheumatol. 2009;5(7):382–390.
    1. Kuriya B, Hernández-Díaz S, Liu J, Bermas BL, Daniel G, Solomon DH. Patterns of medication use during pregnancy in rheumatoid arthritis. Arthritis Care Res (Hoboken) 2011;63(5):721–728.
    1. Bender MA. Sickle cell disease. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews®. Seattle, WA: University of Washington; 1993–2016.
    1. Poddar D, Maude GH, Plant MJ, Scorer H, Serjeant GR. Pregnancy in Jamaican women with homozygous sickle cell disease. Fetal and maternal outcome. Br J Obstet Gynaecol. 1986;93(7):727–732.
    1. Van Enk A, Visschers G, Jansen W, Statius van Eps LW. Maternal death due to sickle cell chronic lung disease. Br J Obstet Gynaecol. 1992;99(2):162–163.
    1. Powars DR, Sandhu M, Niland-Weiss J, Johnson C, Bruce S, Manning PR. Pregnancy in sickle cell disease. Obstet Gynecol. 1986;67(2):217–228.
    1. Smith JA, Espeland M, Bellevue R, Bonds D, Brown AK, Koshy M. Pregnancy in sickle cell disease: experience of the cooperative study of sickle cell disease. Obstet Gynecol. 1996;87(2):199–204.
    1. Dauphin-McKenzie N, Gilles JM, Jacques E, Harrington T. Sickle cell anemia in the female patient. Obstet Gynecol Surv. 2006;61(5):343–352.
    1. Koshy M, Burd L, Wallace D, Moawad A, Baron J. Prophylactic red-cell transfusions in pregnant patients with sickle cell disease. A randomized cooperative study. N Engl J Med. 1988;319(22):1447–1452.
    1. Levy HP. Ehlers-danlos syndrome, hypermobility type. In: Pagon RA, Adam MP, Ardinger HH, et al., editors. GeneReviews®. Seattle, WA: University of Washington; 1993–2016.
    1. Rosenbaum TY, Padoa A. Managing pregnancy and delivery in women with sexual pain disorders. J Sex Med. 2012;9(7):1726–1735.
    1. Johnson NS, Harwood EM, Nguyen RH. You have to go through it and have your children: reproductive experiences among women with vulvodynia. BMC Pregnancy Childbirth. 2015;15:114.
    1. Nguyen RH, Stewart EG, Harlow BL. A population-based study of pregnancy and delivery characteristics among women with vulvodynia. Pain Ther. 2012;1(1):2.
    1. Mogren IM, Pohjanen AI. Low back pain and pelvic pain during pregnancy: prevalence and risk factors. Spine (Phila Pa 1976) 2005;30(8):983–991.
    1. Vullo VJ, Richardson JK, Hurvitz EA. Hip, knee, and foot pain during pregnancy and the postpartum period. J Fam Pract. 1996;43(1):63–68.
    1. Wang SM, Dezinno P, Maranets I, Berman MR, Caldwell-Andrews AA, Kain ZN. Low back pain during pregnancy: prevalence, risk factors, and outcomes. Obstet Gynecol. 2004;104(1):65–70.
    1. Fast A, Shapiro D, Ducommun EJ, Friedmann LW, Bouklas T, Floman Y. Low-back pain in pregnancy. Spine (Phila Pa 1976) 1987;12(4):368–371.
    1. Kristiansson P, Svardsudd K, von Schoultz B. Back pain during pregnancy: a prospective study. Spine (Phila Pa 1976) 1996;21(6):702–709.
    1. Brynhildsen J, Hansson A, Persson A, Hammar M. Follow-up of patients with low back pain during pregnancy. Obstet Gynecol. 1998;91(2):182–186.
    1. Gutke A, Ostgaard HC, Oberg B. Predicting persistent pregnancy-related low back pain. Spine (Phila Pa 1976) 2008;33(12):E386–E393.
    1. Albert H, Godskesen M, Westergaard J. Prognosis in four syndromes of pregnancy-related pelvic pain. Acta Obstet Gynecol Scand. 2001;80(6):505–510.
    1. To WW, Wong MW. Factors associated with back pain symptoms in pregnancy and the persistent of pain 2 years after pregnancy. Acta Obstet Gynecol Scand. 2003;82(12):1086–1091.
    1. Norén L, Ostgaard S, Johansson G, Ostgaard HC. Lumbar back and posterior pelvic pain during pregnancy: a 3-year follow-up. Eur Spine J. 2002;11(3):267–271.
    1. LaBan MM, Perrin JC, Latimer FR. Pregnancy and the herniated lumbar disc. Arch Phys Med Rehabil. 1983;64(7):319–321.
    1. MacEvilly M, Buggy D. Back pain and pregnancy: a review. Pain. 1996;64(3):405–414.
    1. Ostgaard HC, Zetherstrom G, Roos-Hansson E. Back pain in relation to pregnancy: a 6-year follow-up. Spine (Phila Pa 1976) 1997;22(24):2945–2950.
    1. Kvorning N, Holmberg C, Grennert L, Aberg A, Akeson J. Acupuncture relieves pelvic and low-back pain in later pregnancy. Acta Obstet Gynecol Scand. 2004;83(3):246–250.
    1. Pennick V, Liddle SD. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev. 2013;8:CD001139.
    1. Liddle SD, Pennick V. Interventions for preventing and treating low-back and pelvic pain during pregnancy. Cochrane Database Syst Rev. 2015;30(9):CD001139.
    1. Stuge B, Hilde G, Vollestad N. Physical therapy for pregnancy-related low back and pelvic pain: a systematic review. Acta Obstet Gynecol Scand. 2003;82(11):983–990.
    1. Stuge B, Veierod MB, Laerum E, Vollestad N. The efficacy of a treatment program focusing on specific stabilizing exercises for pelvic girdle pain after pregnancy: a two-year follow-up of a randomized clinical trial. Spine (Phila Pa 1976) 2004;29(10):E197–E203.
    1. Elden H, Fagevik-Olsen M, Ostgaard HC, Stener-Victorin E, Hagberg H. Acupuncture as an adjunct to standard treatment for pelvic girdle pain in pregnant women: randomised double-blinded controlled trial comparing acupuncture with non-penetrating sham acupuncture. BJOG. 2008;115(13):1655–1668.
    1. Depledge J, McNair PJ, Keal-Smith C, Williams M. Management of symphysis pubis dysfunction during pregnancy using exercise and pelvic support belts. Phys Ther. 2005;85(12):1290–1300.
    1. Nilsson-Wikmar L, Holm K, Oijerstedt R, Harms-Ringdahl K. Effect of three different physical therapy treatments on pain and activity in pregnancy women with pelvic girdle pain: a randomized clinical trial with 3, 6, and 12 months follow-up postpartum. Spine (Phila Pa 1976) 2005;30(8):850–856.
    1. Haugland KR, Rasmussen S, Daltveit AK. Group intervention for women with pelvic girdle pain in pregnancy. A randomized controlled trial. Acta Obstet Gynecol Scand. 2006;85(11):1320–1326.
    1. Bayliss AJ, Klene FJ, Gundeck EL, Loghmani MT. Treatment of a patient with post-natal chronic calf pain utilizing instrument-assisted soft tissue mobilization: a case study. J Man Manip Ther. 2011;19(3):127–134.
    1. Thomas CT, Napolitano PG. Use of acupuncture for managing chronic pelvic pain in pregnancy. A case report. J Reprod Med. 2000;45(11):944–946.
    1. Eisenach JC, Pan P, Smiley RM, Lavand’homme P, Landau R, Houle TT. Resolution of pain after childbirth. Anesthesiology. 2013;118(1):143–151.
    1. Paterson LQ, Davis SN, Khalife S, Amsel R, Binik YM. Persistent genital and pelvic pain after childbirth. J Sex Med. 2009;6(1):215–221.
    1. Eisenach JC, Pan PH, Smiley R, Lavand’homme P, Landau R, Houle TT. Severity of acute pain after childbirth, but not type of delivery, predicts persistent pain and postpartum depression. Pain. 2008;140(1):87–94.
    1. Hannah ME, Hannah WJ, Hodnett ED, et al. Term Breech Trial 3-Month Follow-up Collaborative Group Outcomes at 3 months after planned cesarean vs planned vaginal delivery for breech presentation at term: the international randomized Term Breech Trial. JAMA. 2002;287(14):1822–1831.
    1. Hannah ME, Whyte H, Hannah WJ, et al. Term Breech Trial Collaborative Group Maternal outcomes at 2 years after planned cesarean section versus planned vaginal birth for breech presentation at term: the international randomized Term Breech Trial. Am J Obstet Gynecol. 2004;191(3):917–927.
    1. Vermelis JM, Wassen MM, Fiddelers AA, Nijhuis JG, Marcus MA. Prevalence and predictors of chronic pain after labor and delivery. Curr Opin Anaesthesiol. 2010;23(3):295–299.
    1. Lavand’homme P. Chronic pain after childbirth. Curr Opin Anaesthesiol. 2013;26:273–277.
    1. Nikolajsen L, Sorensen HC, Jensen TS, Kehlet H. Chronic pain following caesarean section. Acta Anaesthesiol Scand. 2004;48(1):111–116.
    1. Sng BL, Sia AT, Quek K, Woo D, Lim Y. Incidence and risk factors for chronic pain after caesarean section under spinal anaesthesia. Anaesth Intensive Care. 2009;37(5):748–752.
    1. Liu TT, Raju A, Boesel T, Cyna AM, Tan SG. Chronic pain after cesarean delivery: an Australian cohort. Anaesth Intensive Care. 2013;41(4):496–500.
    1. Niklassen B, Georgsson Ohmann S, Segerdahl M, Blanck A. Risk factors for persistent pain and its influence on maternal wellbeing after cesarean section. Acta Obstet Gynecol Scand. 2015;94(6):622–628.
    1. Declercq E, Cunningham DK, Johnson C, Sakala C. Mothers’ reports of postpartum pain associated with vaginal and cesarean deliveries: results of a national survey. Birth. 2008;35(1):16–24.
    1. Shahin AY, Osman AM. Parietal peritoneal closure and persistent postcesarean pain. Int J Gynaecol Obstet. 2009;104(2):135–139.
    1. Ortner CM, Turk DC, Theodore BR, Siaulys MM, Bollag LA, Laundau R. The Short-Form McGill Pain Questionnaire-Revised to evaluate persistent pain and surgery-related symptoms in healthy women undergoing a planned cesarean delivery. Reg Anesth Pain Med. 2014;39(6):478–486.
    1. Kainu JP, Sarvela J, Tiippana E, Halmesmaki E, Korttila KT. Persistent pain after caesarean section and vaginal birth: a cohort study. Int J Obstet Anesth. 2010;19(1):4–9.
    1. Turmo M, Echevarria M, Rubio P, Almeida C. Development of chronic pain after episiotomy. Rev Esp Anestesiol Reanim. 2015;62(8):436–442.
    1. Lavand’homme P. Chronic pain after vaginal and cesarean delivery: a reality questioning our daily practice of obstetric anesthesia. Int J Obstet Anesth. 2010;19(1):1–2.
    1. Lavand’homme P. Postcesarean analgesia: effective strategies and association with chronic pain. Curr Opin Anaesthesiol. 2006;19(3):244–248.
    1. Richez B, Ouchchane L, Guttmann A, et al. The role of psychological factors in persistent pain after cesarean delivery. J Pain. 2015;16(11):1136–1146.
    1. Ostgaard HC, Roos-Hansson E, Zetherstrom G. Regression of back and posterior pelvic pain after pregnancy. Spine (Phila Pa 1976) 1996;21(23):2777–2780.
    1. Loughnan BA, Carli F, Romney M, Dore CJ, Gordon H. Epidural analgesia and backache: a randomized controlled comparison with intramuscular meperidine for analgesia during labour. Br J Anesth. 2002;89(3):466–472.
    1. de Brito Cançado TO, Omais M, Ashmawi HA, Torres ML. Chronic pain after cesarean section. Influence of anesthetic/surgical technique and postoperative analgesia. Rev Bras Anestesiol. 2012;62(6):762–774.
    1. Loos MJ, Scheltinga MR, Roumen RM. Surgical management of inguinal neuralgia after a low transverse Pfannenstiel incision. Ann Surg. 2008;248(5):880–885.
    1. Sia AT, Sng BL, Lim EC, Law H, Tan EC. The influence of ATP-binding cassette sub-family B member-1 (ABCB1) genetic polymorphisms on acute and chronic pain after intrathecal morphine for caesarean section: a prospective cohort study. Int J Obstet Anesth. 2010;19(3):254–260.
    1. Landau R, Bollag L, Ortner C. Chronic pain after childbirth. Int J Obstet Anesth. 2013;22(2):133–145.
    1. Gizzo S, Andrisani A, Noventa M, et al. Caesarean section: could different transverse abdominal incision techniques influence postpartum pain and subsequent quality of life? A systematic review. PLoS One. 2015;10(2):e0114190.
    1. Ghahiry A, Rezaei F, Karimi Khouzani R, Ashrafinia M. Comparative analysis of long-term outcomes of Misgav Ladach technique cesarean section and traditional cesarean section. J Obstet Gynaecol Res. 2012;38(10):1235–1239.
    1. Paech MJ, Magann EF, Doherty DA, Verity LJ, Newnham JP. Does magnesium sulfate reduce the short- and long-term requirements for pain relief after caesarean delivery? A double-blind placebo-controlled trial. Am J Obstet Gynecol. 2006;194(6):1596–1602.
    1. Ducic I, Moxley M, Al-Attar A. Algorithm for treatment of postoperative incisional groin pain after cesarean delivery or hysterectomy. Obstet Gynecol. 2006;108(1):27–31.
    1. Loos MJ, Scheltinga MR, Mulders LG, Roumen RM. The Pfannenstiel incision as a source of chronic pain. Obstet Gynecol. 2008;111(4):839–846.
    1. Gutierrez S, Liu B, Hayashida K, Houle TT, Eisenach JC. Reversal of peripheral nerve injury-induced hypersensitivity in the postpartum period: role of spinal oxytocin. Anesthesiology. 2013;118(1):152–159.
    1. Scriven MW, Jones DA, McKnight L. The importance of pubic pain following childbirth: a clinical and ultrasonographic study of diastasis of the pubic symphysis. J R Soc Med. 1995;88(1):28–30.
    1. Niederhauser A, Magann EF, Mullin PM, Morrison JC. Resolution of infant shoulder dystocia with maternal spontaneous symphyseal separation: a case report. J Reprod Med. 2008;53(1):62–64.
    1. Senechal PK. Symphysis pubis separation during childbirth. J Am Board Fam Pract. 1994;7(2):141–144.
    1. Björklund K, Berström S, Nordstöm ML, Ulmsten U. Symphseal distention in relation to serum relaxin levels and pelvic pain in pregnancy. Acta Obstet Gynecol Scand. 2000;79(4):269–275.
    1. Hou Z, Riehl JT, Smith WR, Strohecker KA, Maloney PJ. Severe postpartum disruption of the pelvic ring: report of two cases and review of the literature. Patient Saf Surg. 2011;5(1):2.
    1. Musumeci R, Villa E. Symphysis pubis separation during vaginal delivery with epidural anesthesia. Case report. Reg Anesth. 1994;19(4):289–291.
    1. Parker JM, Bhattacharjee M. Images in clinical medicine. Peripartum diastasis of the symphysis pubis. N Engl J Med. 2009;361(19):1886.
    1. Henry L. Chiropractic management of postpartum pubic symphysis diastasis: A case report. J Can Chiropr Assoc. 2015;59(1):30–36.
    1. Snow RE, Neubert AG. Peripartum pubic symphysis separation: a case series and review of the literature. Obstet Gynecol Surv. 1997;52(7):438–443.
    1. Idrees A. Management of chronic symphysis pubis pain following child birth with spinal cord stimulator. J Pak Med Assoc. 2012;62(1):71–73.
    1. Fitzgerald CM, Plastaras C, Mallinson T. A retrospective study on the efficacy of pubic symphysis corticosteroid injections in the treatment of pubic symphysis pain. Pain Med. 2011;12(12):1831–1835.
    1. Dowell D, Haegerich TM, Chou R. CDC Guideline for prescribing opioids for chronic pain – United States, 2016. MMWR Recomm Rep. 2016;65(1):1–49.

Source: PubMed

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