Pain syndrome due to dorsopathy in prospects of pregnancy [БОЛЕВОЙ СИНДРОМ ПРИ ДОРСОПАТИИ В ПЕРСПЕКТИВЕ БЕРЕМЕННОСТИ]

Dorsopathy is diagnosed in 25-90 % of pregnant women, in 40 % of women it persists for 14-18 months after delivery. The leading symptom complex of dorsopathy is low back pain, pelvic girdle pain and their combination. The consequences of underdiagnosis of dorsopathies are expressed in the erroneous diagnosis of «Threatened miscarriage» and the unreasonable appointment of hormone therapy with progestins. The etiopathogenesis of neurological syndromes of the lumbar spine that developed during pregnancy is diverse and not yet fully understood. Its basis is formed by hormonal changes (increased levels of progesterone, estrogen, relaxin), which, possibly, contribute to a change in the structure of articular ligaments. The increasing weight of the uterus leads to a shift in the center of gravity of the pregnant woman, hyperlordosis of the lumbar spine and tilt of the pelvis anteriorly, tilt of the neck forward, extension of the head and upper back, extension of the knees, flattening of the feet. Vascular changes due to pregnancy contribute to impaired blood supply to muscle structures in the lower back and pelvic organs, although no reliable evidence has yet been obtained. Promising are the studies of molecular markers of the structurally functional usefulness of tendons and ligaments, which determine the activity of all musculoskeletal components. An objective assessment of pain due to dorsopathies during pregnancy remains extremely difficult and not always feasible. Prevention and the choice of effective therapy during pregnancy for variants of dorsopathies remain debatable and limited. This review systematizes modern ideas on this issue. © 2020 Stavropol State Medical University. All rights reserved.