How to manage persistent pelvic pain after birth?

At this #BlueJC in May, the Blue Journal Club has teamed up with the International Pelvic Pain Society (IPPS) for a joint Twitter Journal Club. We will discuss “Breastfeeding and pelvic girdle pain: a follow-up study of 10 603 women 18 months after delivery” by Bjelland and co-workers from 27 May 2015 for 7 days.

*This paper has been made FREE-TO-VIEW. 

#BlueJC are now on LinkedIn too: http://linkd.in/1BVrpad (simply ask to join)!

Start date: 27 May 2015 (the discussion will open for 7 days between May 27 – June 3)

First hosted discussion session(s) starts at: PST 7pm (1900)*** please note time zone difference!

Host: @intpelvicpain (Brad Fenton) and @BlueJCHost

Twitter hastags: #BlueJC and #IPPSJC

Platforms: Twitter and LinkedIn

The Blue Journal Club is an international journal club on women’s health research based on Twitter (as @BlueJCHost). We start our conversation on the last Wednesday of every month and use the hashtag #BlueJC for our tweets. Simply add this hashtag (“#BlueJC”) to each tweet and we will capture it. Each #BlueJC opens for 7 days from the advertised start time. All BJOG #BlueJC papers also have complementary slide sets suitable for face-to-face journal clubs with your local colleagues. You can access the slide set of this paper with the Journal Club material.

The discussion points are attached below (quoted from the published manuscript)

Scenario

A woman who is 32 weeks pregnant with her second child comes to see you because she is worried about persistent pelvic girdle pain afterbirthshe had pelvic pain for 20 months after an uncomplicated vaginal delivery of her first child 3 years ago. She is overweight (body mass index = 27 kg/m2), has no other significant medical history and has had no complications during this pregnancy. How do you counsel this woman?

Description of research

Participants

Women who had singleton deliveries in the Norwegian Mother and Child Cohort Study and reported pelvic girdle pain at 0– 3 months postpartum

Intervention

Breastfeeding (coded as bottle-feeding, partial breastfeeding, and full breastfeeding).

Comparison

Four self-administered questionnaires about pelvic pain at second and third trimesters of pregnancy, as well as 6 and 18 months after birth

Outcomes

Persistent pelvic pain at 18 months after birth, defined as having combined anterior and bilateral posterior pelvic pain.

Study design

Population-based cohort study

Discussion Points

  • How do you currently manage women with persistent pelvic pain after birth?

  • What is the Norwegian Mother and Child Cohort Study (www.fhi.no/morogbarn)?

  • Were the analyses of the current study planned prospectively?

  • The majority of women in this study breast-fed for at least 3 months after birth. How does this breastfeeding rate compare

    with that of women in your daily practice?

  • Women who did not breastfeed at all were not more likely to have persistent pelvic girdle pain. How does this affect your interpretation of this study? (See suggested reading)

  • What are the potential study designs that could be used to evaluate further this clinical question?

  • How do the results of this study change your understanding on persistent pelvic pain after birth?

Suggested reading

  • Schunemann H, Hill S, Guyatt G, Akl EA, Ahmed F. The GRADE approach and Bradford Hill’s criteria for causation. J Epidemiol Community Health. 2011;65:392-5.

For those who want to understand hashtags, this may be a useful guide. For an introduction to #BlueJC, please refer to BJOG 2013;120:657–60. Follow @BlueJCHostthis blog and our Facebook page to receive news about #BlueJC.

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