Wyniki wyszukiwania - Biblioteka Nauki

1

Physiotherapy in women with diastasis of the rectus abdominis muscles

100%

Bobowik P. Ż. , Dąbek A.

Advances in Rehabilitation

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2018

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tom 32

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nr 3

11-17

EN

Background Diastasis of the rectus abdominis muscles (DRAM) is the separation of the two rectus abdominis muscles more than 2 cm wide. It often arises as a result of android obesity, dysfunctional abdominal cramp and pregnancy. Untreated diastasis may lead to dangerous heath consequences such as.: abdominal hernia, lower back pain or disorders in pelvis’s area. The aim of this study was to determinate the effectiveness of novel physiotherapeutic program in women with diastasis of the rectus abdominis muscles. Material and methods The study was conducted on a group of 40 women between 20-45 years old (mean 32,32+5,9 year). They all were qualified in obstetric ward of Szpital Bielański in Warsaw. All of them were in the postpartum between 0-3 days after labor and have DRAM greater than 2 cm (measured by palpation on the umbilicus height, 4,5 cm above and below umbilicus). In research group (included 20 women) applied novel physiotherapeutic program aimed at reduction of DRAM. In controlled group (20 women) there was no therapy but only observation of spontaneous reduction of diastasis. The study took 6 weeks. Results Data analysis had shown 95% effectiveness of novel physiotherapeutic program. Chi-square test has confirmed the difference in DRAM size in both groups (p<0,0001). A statistically significant correlation was demonstrated between width of diastasis and growth of the mother’s weight gain in pregnancy, waist-to-hip ratio, BMI, number of delivery and mother’s physical activity before and during pregnancy (p<0,05). There wasn’t clear correlation between width of diastasis and mother’s age or infant’s mass (p>0,05). Conclusions It seems that spontaneous reduction of diastasis of the rectus abdominis muscles is very rare. New physiotherapeutic program is an effective method in DRAM’s reduction. The research should be continued in larger group of women and after effectiveness confirmation, program should be introduced in obstetric wards.

2

Exercises for pregnant and postpartum women with diastasis recti abdominis – literature review

100%

Gruszczyńska D. , Truszczyńska-Baszak A.

Advances in Rehabilitation

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2018

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tom 32

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nr 3

27-35

EN

Introduction Diastasis recti abdominis is a pathological condition at the linea alba in which rectus abdominis muscles separate. It occurs mainly in pregnant and postpartum women. Changes in the linea alba area are caused by stress to the tissue and pregnancy induced hormonal changes which lead to the loosening of abdominal connective tissue. This pathological condition is not manifested with any pain symptoms but the effects which may develop as a result of diastasis recti abdominis may cause pain. This literature review study discusses the non-surgical methods of treating diastasis recti abdominis by reducing the distance between the two parts of the rectus abdominis muscle. Material and methods Scientific literature on physiotherapy, surgical treatment and diagnostics of diastasis recti abdominis in pregnant and postpartum women from the last 15 years was analysed. Such databases as Google Scholar, PubMed, ScienceDirect, Ebsco and MedLine were used in the analysis and 11 publications were considered. Results Having analysed the available literature, it was concluded that abdominal exercises can prevent or reduce diastasis recti abdominis. However, the analysis did not reveal which method of treatment was the most effective. Conclusions This review of the literature revealed that there is not currently a gold standard method of treating diastasis recti abdominis. However, abdominal exercises during pregnancy reduce the risk of this condition postpartum. Diastasis recti abdominis may be reduced even a few years after childbirth by implementing appropriate treatment including a special training programme focusing on strengthening anterior abdominal wall and learning to maintain a proper body posture during activities of daily living.

3

Biznesowe aspekty funkcjonowania chińskich klinik poporodowych – analiza socjologiczno-ekonomiczna

86%

Afek J. , Krupa D.

Kultura i Edukacja

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2016

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nr 3(113)

107-119

EN

The tradition of ‘sitting the month’ derived from China is still a practiced custom to have a postpartum month after childbirth. Traditional rules applicable in a postpartum period were to help women rejuvenate their bodies after childbirth, to restore the balance of the body and ensure its future health. Today’s intensive economic development of China along with the increase in Chinese people’s savings contributes to creating a special and sophisticated offer for affluent social groups. An example of such an offer are postnatal clinics designed for wealthy Chinese women who want to have their postnatal period in accordance with traditional practices. The objective of this article is to show the business aspects of Chinese contemporary postnatal clinics and attempt to answer the question on how modern postnatal clinics combine tradition with modernity to make life easier for mothers, and to what extent they are another idea for doing business. The article addresses the major factors of the demographic and economic environment, which may have an impact on the prosperity of society and on the development of the market of postnatal clinics in the region. It also presents the essence of traditional postpartum practices in China. Offers of services to mothers and their children from fortysix clinics from Taipei in Taiwan were also analysed. It turns out that postnatal clinics are a phenomenon that could occur only within the Asian community. It is a product, which is very well inscribed in the Asian mentality and cannot be transferred to any another, such as, for instance, to the European mentality. Its future is limited to the Asian markets, or, possibly, to countries which have a Chinese diaspora on their territory. Over time, along with the spread of this traditional practice with a modern twist, the number of postnatal clinics can grow, which can translate into lower prices, a worse quality and a narrower range of services offered.

4

Postpartum takotsubo cardiomyopathy complicated with severe pulmonary edema and cardiogenic shock – a case report

86%

Bembey R. A. , Jha R. R.

European Journal of Clinical and Experimental Medicine

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2023

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nr 1

163-168

EN

Introduction and aim. Takotsubo cardiomyopathy (TCM) is a rare but life-threatening illness that can affect middle aged, young and pregnant women. It is a cardiac emergency and can mimic many other life threatening conditions like myocardial infarction, acute myocarditis, peripartum cardiomyopathy or dilated cardiomyopathy and is diagnosed by exclusion. Description of the case. Here we report a rare case of takotsubo cardiomyopathy in a young 28 year old female immediately post vaginal delivery of her normal full term twin pregnancy, who was otherwise a healthy female. She went on to develop complication of left ventricular heart failure and cardiogenic shock, which were successfully managed by conservative treatment leading to a full recovery. Conclusion. Takotsubo or stress cardiomyopathy is a rare entity and often a missed diagnosis, which if caught on time and treated leads to great prognosis. Our patient made a full recovery and is living a healthy life.

5

A prospective longitudinal comparison of the sacral inclination angle in women between their early and advanced pregnancy and 6-month postpartum follow-up

72%

Opala-Berdzik A. , Cieślińska-Świder J. , Gnat R.

Acta of Bioengineering and Biomechanics

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2019

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tom Vol. 21, no. 3

127--134

EN

The impact of pregnancy on the anterior-posterior sacral orientation and its relation to lumbopelvic pain and weight gain has not been fully recognized. This longitudinal study aimed to compare the sacral inclination angle in women between their early and advanced pregnancy and at 6 months postpartum. The authors also searched for a correlation between the sacral inclination and lumbopelvic pain, BMI and change in body mass. Methods: Thirteen healthy women participated in the study. Data were collected at 8–16 and 35–38 weeks of gestation, and at 27–31.5 postpartum weeks. At each session, the women’s sacral inclination angles were measured using the Saunders digital inclinometer. Data were also collected on lumbopelvic pain, BMI and body mass gain/loss. Results: There was no effect of the evaluation period on the sacral inclination ( p > 0.05); however, various individual values of the sacral inclination in pregnancy and postpartum were noted. In advanced pregnancy, 61.5% of the women had recurrent pain in the lumbopelvic region. The sacral inclination did not correlate with the lumbopelvic pain, BMI and body mass change ( p > 0.05) in the pregnancy and postpartum periods. Conclusions: Advanced pregnancy did not influence sacral inclination. However, individuals varied in their responses. Therefore, we suggest that an individually-based physical therapy approach concerning proper posture during and after pregnancy should be emphasized. The sacral inclination had no impact on the occurrence of recurrent lumbopelvic pain. BMI and changes in body mass did not influence the sacral inclination in advanced pregnancy and at 6 months postpartum.

6

Diastasis of the rectus abdominis muscle in early postpartum women

72%

Matloch D. , Opala-Berdzik A. , Stanula A. , Ciszek M. , Kucio C.

Medical Rehabilitation

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2019

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tom 23(1)

11-15

PL

Cel pracy: Rozejście mięśni prostych brzucha to poszerzenie kresy białej i rozsunięcie brzuśców mięśni prostych na boki. Problem ten najczęściej dotyczy kobiet w ciąży i po porodzie. Celem pracy było sprawdzenie częstości występowania rozstępu mięśni prostych brzucha u kobiet we wczesnym połogu oraz odpowiedź na pytanie, czy istnieje zależność pomiędzy szerokością kresy białej a liczbą przebytych porodów. Metody: W pracy wykorzystano dane z wywiadu oraz wyniki testu na rozpoznanie rozejścia mięśni prostych brzucha wykonanego u 52 kobiet będących między trzecią a piątą dobą po porodzie. Do zbadania zależności między zmiennymi wykorzystano test niezależności chi2 Pearsona. Do określenia siły związku pomiędzy cechami zastosowano współczynnik korelacji rangowej Spearmana. Wyniki: U 33 z 52 kobiet (63%) stwierdzono rozejście mięśni prostych brzucha na wysokości pępka. Analiza statystyczna wykazała umiarkowaną dodatnią zależność pomiędzy szerokością kresy białej a liczbą przebytych porodów (r = 0,4; p < 0,05). Rozejście mięśni prostych brzucha dotyczyło 14 z 28 pierworódek (50%) oraz 19 z 24 wieloródek (79%; p < 0,05). Wnioski: Wyniki niniejszej pracy wskazują, że problem rozejścia mięśni prostych brzucha dotyczył ponad połowy kobiet we wczesnym połogu. U wieloródek może istnieć większe ryzyko wystąpienia rozejścia mięśni prostych niż u pierworódek.

EN

Aim of study: Diastasis recti abdominis is a widening of the linea alba leading to separation of the recti muscles. This abnormality concerns mainly women during their perinatal period. The objective of this study is to determine the incidence of diastasis recti abdominis in women during their early postpartum period. We also attempted to verify the relationship between the women’s linea alba width and the number of their deliveries. Methods: In this study, data from medical interviews as well as the results of a diastasis recti test among 52 women between their 3rd and 5th day after delivery were analysed. Pearson’s Chi2 and Spearman’s correlation tests were used to search for relationships between variables. Results: Among the 52 women, 33 (63%) demonstrated increased separation of recti muscles (a positive diastasis recti test at the level of the umbilicus). Statistical analysis indicated a moderate positive correlation between the width of linea alba and the number of deliveries (r = 0.4; p < 0.05). Diastasis recti abdominis occurred in 14 of the 28 primigravidas (50%) and in 19 of the 24 multigravidas (79%; p < 0.05). Conclusions: The results of this study indicate that over half of the women in the early postpartum period had diastasis of the recti abdominis muscles. In multiparous women, there may be a higher risk of diastasis recti abdominis occurrence.

7

Physiotherapy in diastasis of the rectus muscles of abdomen in women during pregnancy and postpartum

72%

Opala-Berdzik A. , Dąbrowski S.

Physiotherapy

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2009

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tom 17

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nr 4

67-70

PL

Celem artykułu jest wskazanie problemu rozstępu mięśni prostych brzucha u kobiet w ciąży i po porodzie oraz zaproponowanie postępowania fizjoterapeutycznego w oparciu o dostępną literaturę. Do rozstępu mięśni prostych brzucha dochodzi najczęściej w ostatnim trymestrze ciąży. Po porodzie mięśnie proste nie zawsze samoistnie powracają do prawidłowego położenia. Pozostają one znacznie osłabione, a ich funkcja jest zaburzona, co może prowadzić do nieprawidłowej postawy ciała i przewlekłych bólów krzyża. Aby zmniejszyć ryzyko takich powikłań, zaleca się rutynowe stosowanie testu na rozpoznanie rozstępu mięśni prostych brzucha w ciąży i w połogu. W przypadku stwierdzenia rozstępu bardzo ważne są zalecenia odnośnie do wykonywania codziennych czynności, jak również odpowiedni dobór ćwiczeń w postępowaniu fizjoterapeutycznym. W artykule zawarte są wskazówki dotyczące modyfikacji ćwiczeń mięśni brzucha oraz opis ćwiczenia terapeutycznego zalecanego w przypadku rozstępu mięśni prostych brzucha po porodzie.

EN

The purpose of this article is to show the problem of diastasis of the rectus muscles of abdomen during pregnancy and after birth in women and to suggest physical therapy based on the available literature. Diastasis of the rectus muscles of abdomen usually appears in the last trimester of pregnancy. After birth the rectus muscles do not always return to normal. The abdominal muscles remain significantly weakened and their functioning is impaired what may lead to incorrect body posture and chronic low back pain. In order to reduce the risk of such complications it is recommended to routinely perform the test for diastasis of the rectus muscles of abdomen in pregnancy and postpartum. If diastasis of the abdominal muscles is found, the indications regarding everyday life activities and a proper selection of exercises are very important in the physiotherapeutic programme. The article includes instructions regarding modifications of the exercises of the abdominal muscles as well as a description of the therapeutic exercise recommended in diastasis of the rectus muscles of abdomen after giving birth.

8

Zaburzenia psychiczne w ciąży i poporodowe oraz ich leczenie

72%

Rzewuska M.

Psychiatria i Psychologia Kliniczna

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2009

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tom 9

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nr 1

7-28

EN

Treating women with psychiatric disorders during pregnancy is a challenge for numerous reasons. Balancing the risk and benefits of the treatment is particularly important during pregnancy because both medication and maternal illness may have adverse effects on the fetus. Psychiatrists can prepare management decisions by reviewing the current literature. In the recurring disturbances, and with a risk of a serious relapse, it is often safer to continue the treatment, rather than to withdraw it. The physician and patient should discuss the known teratogenicity data, as well as acknowledge the unknown or non-quantifiable risks. The lowest effective doses should always be used (divided into several portions throughout the day); polytherapy should be avoided; doses should be adjusted to the period of pregnancy; preparations counteracting the toxic effect of the medication should be used (vitamin K, folic acid). In the prepartum period, the dose of the drug should be maximally reduced. The paper reviews the literature on the characteristic features of psychiatric illness during pregnancy and postpartum period and presents updated knowledge on teratogenicity, neonatal and neurobehavioural effects for different psychotropic drugs (SSRI, TCA, other antidepressants, mood stabilizers, neuroleptics, novel antipsychotics, benzodiazepines), and ECT.

PL

Leczenie kobiet ciężarnych z zaburzeniami psychicznymi wymaga uwzględnienia ryzyka związanego z chorobą i jej nieleczeniem oraz wynikającego z działania leków na rozwój i zdrowie dziecka. Decyzja o leczeniu musi uwzględniać aktualne dane z literatury. W zaburzeniach nawracających i z ryzykiem ciężkiego nawrotu często utrzymanie leczenia jest bezpieczniejsze niż odstawienie leku. Lekarz i pacjentka powinni omówić znane dane o ryzyku działania teratogennego leku, jak również inne dane o efekcie zaniechania i prowadzenia leczenia. Zawsze należy stosować najniższe skuteczne dawki, dzielone na kilka porcji w ciągu doby, unikać politerapii, dostosowywać dawki do okresu ciąży, podawać preparaty zapobiegające toksycznemu działaniu leków (witamina K, kwas foliowy). W okresie przed porodem należy maksymalnie zredukować dawkę podawanego leku. W pracy przedstawiono aktualne dane o zaburzeniach psychicznych w ciąży i połogu oraz o działaniu teratogennym i wpływie na kondycję dziecka i jego rozwój różnych leków psychotropowych (TLPD, SSRI i innych leków przeciwdepresyjnych, klasycznych neuroleptyków i nowych leków przeciwpsychotycznych, stabilizatorów nastroju, benzodiazepin) i elektrowstrząsów.

9

Electrocardiographic changes in pregnancy and postpartum period

72%

Kandzia T. , Markiewicz-Łoskot G.

Annales Academiae Medicae Silesiensis

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2016

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tom 70

9-14

EN

Pregnancy and labor, though a physiological and natural time in a woman’s life, are associated with many changes to the woman’s body. The overall blood volume, cardiac output and heart rate of a pregnant woman differ significantly from pre-pregnancy time. This again has a significant effect on the electrical activity of the heart. Abnormal electric activity of the heart might be confused with an ongoing or commencing heart disease. Moreover, pregnancy, labour and especially the post partum period are also known to increase the risk of cardiac events including arrhythmia, myocardial infarction or even sudden cardiac death, especially in women with a present cardiac disease like LQTS (Long QT Syndrome). In order to reduce the occurrence of adverse cardiac events and enable their early detection and diagnosis, there is a need for a more thorough understanding of electrocardiographic changes occurring during pregnancy. Unfortunately, data regarding changes of the electric activity of the heart during pregnancy are scarce. The aim of this work is to give an outline on the electric activity changes of the heart of a pregnant woman. The available data confirm that intense changes in the cardiovascular system caused by pregnancy strongly affect the electrical activity of the heart.

PL

Ciąża i poród, choć należą do fizjologicznego i naturalnego czasu w życiu kobiety, wiążą się z wieloma zmianami w jej organizmie. Całkowita objętość krwi, rzut serca i tętno u kobiet w ciąży znacznie odbiegają od wartości przedciążowych. Zmiany te mają znaczący wpływ na aktywność elektryczną serca. Zmieniona aktywność elektryczna serca może być mylona z trwającą lub nowo powstałą chorobą serca. Ponadto w okresie ciąży, porodu, a również połogu w sposób istotny zwiększa się ryzyko zdarzeń sercowych, w tym zaburzeń rytmu, zawału serca lub nawet nagłej śmierci sercowej, zwłaszcza u kobiet z chorobą serca w wywiadzie, takich jak LQTS (zespół wydłużonego odcinka QT). W celu zmniejszenia występowania niepożądanych zdarzeń sercowych oraz umożliwienia ich wcześniejszego wykrywania i diagnostyki istnieje potrzeba bardziej dogłębnego zrozumienia zmian elektrokardiograficznych zachodzących w okresie ciąży. Niestety, dane dotyczące zmian elektrokardiograficznych w ciąży są nieliczne. Celem naszej pracy poglądowej jest przedstawienie zarysu zmian elektrycznej aktywności serca u kobiety ciężarnej. Dostępne wyniki badań dowodzą, że intensywne zmiany w układzie krążenia spowodowane ciążą silnie wpływają na aktywność elektryczną serca.

10

Physical activity in pregnancy and its impact on duration of labor and postpartum period

58%

Brzęk A. , Naworska B. , Plasun K. , Famuła A. , Gallert-Kopyto W. , Skrzypulec-Plinta V. , Michalski M. , Sprada Z. , Plinta R.

Annales Academiae Medicae Silesiensis

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2016

|

tom 70

256-264

EN

OBJECTIVES: The aim of the work was to assess the level of physical activity of women before and during pregnancy and to determine whether physical exercise influences the course and duration of labor and the postpartum period. MATERIAL AND METHODS: The study encompassed 63 pregnant women aged 19–36, with a mean pregnancy weight gain of 7–27 kg, no contraindication to physical activity, and term birth. Physical activity was assessed at three stages: before and during pregnancy, and during the postpartum period, with the use of the seven-day international IPAQ questionnaire. The respondents’ physical condition in the postpartum period was assessed with an original 26-item questionnaire. RESULTS: The self-assessed level of physical activity before pregnancy was moderate in most respondents (60.3%); only 12.7% of the respondents declared a low level of physical activity. During pregnancy the level of physical activity decreased in 25.4% of the respondents and significantly reduced in 11%. Women who were inactive before pregnancy remained inactive during pregnancy. The mean duration of the second stage of labor in women with moderate and high levels of physical activity was 43.61 min. The length of the entire postpartum period was the shortest (four weeks) in active women. CONCLUSIONS: Physical activity before and during pregnancy has an impact on the duration of labor and the postpartum period.

PL

CEL PRACY: Celem pracy była ocena poziomu aktywności fizycznej kobiet przed i w trakcie ciąży oraz ustalenie, czy aktywność fizyczna wpływa na trwanie porodu i okres połogu. MATERIAŁ I METODY: Badania przeprowadzono na 63 kobietach w ciąży w wieku 19–36 lat bez przeciwwskazań do aktywności fizycznej, u których odnotowano przyrost ciężaru ciała pomiędzy 7–27 kg. Poziom aktywności fizycznej mierzono trzykrotnie: przed i w trakcie ciąży oraz podczas połogu. W tym celu użyto kwestionariusza IPAQ – wersji siedmiodniowej oraz dodatkowo autorskiego kwestionariusza ankiety składającego się z 26 pytań. WYNIKI: Poziom aktywności fizycznej przed ciążą był u większości badanych kobiet umiarkowany (60,3%), tylko 12,7% kobiet deklarowało niski poziom aktywności fizycznej. W trakcie trwania ciąży poziom tej aktywności obniżył się w 25,4% przypadków i istotnie zmniejszył w 11%. Kobiety, które były nieaktywne przed ciążą, pozostały nieaktywne również w okresie jej trwania. Średni czas II etapu porodu u kobiet o średnim i wysokim poziomie aktywności fizycznej wynosił 43,61 min. Długość okresu połogu była krótsza u kobiet aktywnych i twała średnio 4 tygodnie. WNIOSKI: Aktywność fizyczna przed ciażą i w trakcie jej trwania ma wpływ na fazy porodu oraz długość okresu połogu.