PREGNANCY-BIRTH Messages for December, 1999: Re: PREGNANCY AND RSD

Re: PREGNANCY AND RSD

From: Harvey S. Marchbein, M.D. (anonymous@obgyn.net)
Mon, 27 Dec 1999 19:36:13 -0600 (CST)

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In reply to: JESSICA: "PREGNANCY AND RSD"

At Mon, 27 Dec 1999, JESSICA wrote: >
>I HAVE REFLEX SYMPATHETIC DYSTROPHY SYNDROME AND MIGHT BE PREGNANT I
>HAVE BEEN UNABLE TO FIND ANY INFORMATION AS TO PROBLEMS OR ANY
>INFORMATION REGARDING THIS IF ANYONE COULD HELP I WOULD BE GREATFUL.
>THANKS IN ADVANCE-JESSICA

Seek on the free Medline with courtesy from OBGYN.net and ye shall find. (and all I could find was development of RSD during pregnancy from 9/99). IF you need more info (and who doesn't), you may have to have a neurologist do a literature search or talk to people at University centers.

Reflex sympathetic dystrophy in pregnancy: nine cases and a review of the literature. Eur J Obstet Gynecol Reprod Biol 1999 Sep;86(1):55-63 (ISSN: 0301-2115) Poncelet C; Perdu M; Levy-Weil F; Philippe HJ; Nisand I

Maternity Ward, Poissy Hospital Center, France. nathalie.bridou@bch.ap-hop-paris.fr.

OBJECTIVE: To better understand the diagnosis of reflex sympathetic dystrophy of the lower extremities in pregnant women.

Subject: Disease analysis using a retrospective series of nine cases and a review of the literature (57 patients and 159 sites of reflex sympathetic dystrophy).

RESULTS: This disorder should be considered in any painful pelvic girdle syndrome or lower extremity pain. The hip is involved in 88% of cases. Symptoms develop in the third trimester of pregnancy, between the 26th and the 34th weeks. Magnetic resonance imaging (MRI) provides an early, accurate, and very specific diagnosis, although standard radiography continues to be the first-line diagnostic tool. Fracture occurs in 19% of patients. The etiology and pathophysiology remain unclear, although pregnancy itself appears to play a significant role in this disease. Although locoregional mechanical factors partly explain reflex sympathetic dystrophy. Hypertriglyceridemia appears to be a risk factor. This disorder develops independently, but the conclusion of pregnancy appears to be necessary for cure. Reflex sympathetic dystrophy does not appear to affect the course of the pregnancy. Indications for cesarean delivery remain obstetrical and should be discussed when a fracture is involved. Simple therapeutic management using gentle physical therapy provides rapid and complete recovery in 2-3 months.

CONCLUSION: Reflex sympathetic dystrophy during pregnancy remains poorly understood and underestimated. Only joints of the inferior limbs are involved. MRI appears to be the best diagnostic tool. Pathogenesis remains unclear. Fractures are not rare. Treatment should be non-aggressive.

--
Harvey S. Marchbein, M.D. FACOG, FACS
Great Neck, New York

**Note:  Opinions expressed here are for educational purposes only
and, as such, do not constitute a physician-patient relationship.
This information is not intended to supplant the need for you to
consult with your physician prior to choosing therapeutic options
and/or interventions.

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