Round Ligament Syndrome in the Prepartum Woman

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Presentation transcript:

Round Ligament Syndrome in the Prepartum Woman

Pathomechanics Pain related to the increase in uterus size during pregnancy Round ligament can become over stretched as uterus increases in size Causes pain similar to pelvic and low back pain

Clinical Presentation Most commonly present with pelvic and/or low back pain. Symptoms more severe on the right side of the body - Uterus deviates more to right as it enlarges Pain can range from minor to severe Pain can significantly limit participation in daily activities and work. Pain increases in intensity at night and can occur suddenly during activities such as turning in bed while sleeping.

Diagnosis Thorough and complete medical history along with physical examination must be carried out on clients with suspected round ligament syndrome. This screening can help to identify if the source of the abdominal or pelvic pain in pregnant women could be from a more severe pathological source, indicating the need for referral. Additional pathological causes of round ligament pain can include round ligament lipoma which can mimic acute appendicitis and varicosities which can mimic inguinal hernia.

Intervention and Treatment Recommendations Use of supportive belts Special Pregnancy Exercises Use of pelvic tilt exercise protocols Stabilization Exercises Frequent Rest Yoga and Acupuncture have also been found to have positive effects

References Andrews CM, O'Neill, L.M. Use of Pelvic Tilt Exercise for Ligament Pain Relief. Journal of Nurse-Midwifery. 1994;39(6):370-374. Huancahuari N. Emergencies in early pregnancy. Emergency medicine clinics of North America. Nov 2012;30(4):837-847. FF IJ, Boddeus KM, de Haan HH, van Geldere D. Bilateral round ligament varicosities mimicking inguinal hernia during pregnancy. Hernia : the journal of hernias and abdominal wall surgery. Feb 2009;13(1):85-88. Miller TJ, Paulk DG. Round ligament lipoma mimicking acute appendicitis in a 24-week pregnant female: a case report. Hernia : the journal of hernias and abdominal wall surgery. Apr 2013;17(2):259-261. Pennick VE, Young G. Interventions for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev 2007;(2).