143 lines
6.7 KiB
XML
143 lines
6.7 KiB
XML
import Article from "@/components/Article";
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const ArticleOsteopathicManipulationInPregnancy = () => {
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return (
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<Article
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title="Osteopathic Manipulation in Pregnancy"
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author="Andrea S. Clem, D.O."
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>
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<h2>Overview</h2>
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<p>
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During pregnancy, a woman’s body undergoes many anatomic (structural),
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circulatory (fluid), and hormonal changes that may lead to various
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musculoskeletal complaints, increase her risk of injury, or alter the
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course of pre-existing conditions. Some of the more common complaints
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include low back and pelvic pain, carpal tunnel syndrome, headache,
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nausea, vomiting, and edema. Approximately 2/3 of women with rheumatoid
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arthritis will have improvement in their symptoms during pregnancy but
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may suffer a flare-up in the post partum period. Many women with
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ankylosing spondylitis may have an exacerbation of symptoms. Women with
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scoliosis have no increased risk over non pregnant women for
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progression. [1,2]
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</p>
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<p>
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Most of the symptoms encountered can be attributed to the development
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and growth of the fetus and are often specific to the different
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trimesters of the pregnancy. Osteopathic manipulation can play an
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important role in providing relief for the common complaints throughout
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the various stages of pregnancy, delivery, and the post partum period.
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</p>
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<h2>First Trimester</h2>
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<p>
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Common conditions in the first trimester include heartburn as well as
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nausea and vomiting (“morning sickness”). Structural dysfunction is
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often found at the spinal levels related to the nervous system supply to
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the organs involved. Osteopathic manipulation to the cervical and
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thoracic spine can be used to influence these nervous system inputs,
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providing relief for gastrointestinal complaints. [3]
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</p>
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<h2>Second Trimester</h2>
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<p>
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As the uterus increases in size, pain may be felt through the round
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ligaments and the pubic symphysis. Once it expands from the pelvis in to
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the abdomen, the diaphragm becomes elevated affecting breathing. Fascial
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release through the abdomen, ribcage, and diaphragms may improve
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respiration and prevent or alleviate backache, sciatica, cramps or
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posterior pelvic pain. The second most common complaint in the second
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trimester is hand and wrist pain resulting from localized swelling.
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Anywhere from 1% -25% of all pregnant women may exhibit the classic
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carpal tunnel syndrome symptoms of numbness, tingling, and night-time
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pain. Since it almost always resolves after delivery, conservative
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treatment is recommended. This would include night time splinting and
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manipulative treatment aimed at improving lymphatic flow and releasing
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tension at the wrist. [1,3]
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</p>
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<h2>Third Trimester</h2>
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<p>
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Mechanical and structural changes are at their greatest in the third
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trimester. These result in changes in gait, loss of balance, and low
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back pain. Gravitational effects from the uterus in the abdomen and
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pelvis cause pressure that decreases lymphatic and venous return from
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the lower extremities leading to edema and hemorrhoids. Constipation and
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reflux are also common. Osteopathic manipulation to the pelvic floor and
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mid thoracic and lumbar spine helps to mobilize fluid and relieve these
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complaints.
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</p>
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<h2>Labor & Delivery</h2>
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<p>
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During labor, Osteopathic manipulation focused at the lower thoracic and
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lumbar areas can influence the nerves that supply the pelvic organs.
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Soft tissue and myofascial treatment of the pelvis and sacrum can help
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to maintain good mobility of the sacrum, allow for proper rotation and
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descent of the fetal head, and influence cervical dilation. Osteopathy
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in the Cranial Field has been shown in studies to influence uterine
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contractility and help to overcome uterine inertia by its effect on the
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pituitary secretion of oxytocin. [4, 5]
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</p>
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<h2>Post Partum</h2>
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<p>
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Throughout pregnancy, a woman’s body produces the hormone relaxin. This
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allows the joints of the pelvis to become flexible for the fetus to
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pass. It is also responsible for the increased joint laxity that can
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lead to the dysfunctions that occur during pregnancy and delivery. Since
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the serum levels of relaxin return to near normal three days post
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partum, treatment immediately after delivery can help to re-align the
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sacropelvic structures that have just undergone the stress of pushing
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and positioning in stirrups. Later follow-up with osteopathic
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manipulation is useful for the treatment of any persistent pain in the
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low back or pelvis.
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</p>
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<h2>Contraindications</h2>
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<p>
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In most cases, the use of Osteopathic manipulation in pregnancy is both
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safe and effective. Conditions where it should not be used include:
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premature labor, abruption placentae, rupture of membranes without
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labor, incompetent cervix, eclampsia, and ectopic pregnancy. 5
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</p>
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<h2>Summary</h2>
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<p>
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Pregnancy is a time where a women’s body undergoes many changes-often
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resulting in some form of musculoskeletal complaint. Osteopathic
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manipulation can serve as a valuable adjuvant therapy in the normal
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obstetrical care. By providing relief from pain, maintaining homeostasis
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and circulation, and supporting labor and delivery, pregnancy can be a
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more comfortable and enjoyable experience.
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</p>
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<h2>References</h2>
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<p>
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1. Ireland M, Ott S. The Effects of Pregnancy on the Musculoskeletal
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System. Clinical Orthopaedics and Related Research. 2000. 372:169-179.
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</p>
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<p>
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2. Jones A, Lockwood M. Osteopathic Manipulative Treatment in Pregnancy
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and Augmentation of Labor: A Case Report. AAO Journal. 18:1 March 2008:
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27-29.
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</p>
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<p>
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3. Ward R. Foundations for Osteopathic Medicine. 2nd ed. Philadelphia,
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PA: Lippincott Williams & Wilkins; 2003: 450-461.
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</p>
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<p>
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4. McAfee S, Chila A. Occipital Compression and its Potential Uses in
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Obstetrics. AAO Journal. 17:3 September 2007: 27-29.
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</p>
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<p>
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5. DiGiovanna E, Schiowitz S, Dowling D. An Osteopathic Approach to
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Diagnosis and Treatment 3rd ed. Philadelphia, PA: Lippincott Williams
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& Wilkins; 2005: 651-659.
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</p>
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</Article>
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);
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};
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export default ArticleOsteopathicManipulationInPregnancy;
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