Round Ligament Syndrome
Pathomechanics
Clinical Presentation
Diagnosis
- 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.
Interventions 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, and O'Neill, LM. 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, and 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, and 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, and Young, G. Interventions for Preventing and Treating Pelvic and Back Pain in Pregnancy. Cochrane Database Syst Rev 2007;(2).
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