Osteopathic status of maternity patients after spinal anesthesia and the possibility of its correction
Authors: Bobrova A. S. , Shkryabina A. M. , Khatkevich A. K. , Nenashkina E. N. 
Published: June 2022

Introduction. Spinal anesthesia (SA) is one of the most versatile and reliable methods used for pain relief in obstetric patient groups. However, like any other method of anesthesia, spinal anesthesia in some cases can be associated with the risk of complications and side effects. These effects may include developing functional disorders (somatic dysfunctions), timely diagnosis and correction of which can prevent the development of pathology. Evaluation of the impact of SA on the osteopathic status of patients, as well as the use of non-drug methods (including osteopathic correction) for treating side effects after using SA, taking in consideration the lack of the possibility of using drug correction methods in the postpartum period, has an interest to the practitioner. The aim of the study is to study the osteopathic status of maternity patients (puerperas) after spinal anesthesia and the possibility of its osteopathic correction.

Materials and methods. The study involved 140 women aged 20 to 30 years with a pregnancy of 38–41 weeks. Three groups were formed by simple randomization: the main group (50 people, participants received spinal anesthesia during childbirth and osteopathic correction after childbirth), the control group (50 people, participants did not receive spinal anesthesia during childbirth, but received osteopathic correction after childbirth), and comparison group (40 people, participants received spinal anesthesia during childbirth, but did not receive osteopathic correction after childbirth). All participants were assessed for osteopathic status and the presence of soreness during palpation at typical painful points. The examination was carried out three times: before childbirth, after childbirth, and after the course of correction in the main and control groups (in the comparison group, this was, respectively, the second postpartum examination).

Results. In the postpartum period, the participants of the main group and the comparison group (who received SA) were characterized by a statistically signiﬁ cant (p<0,05) increase in the detection frequency of global rhythmogenic cranial disorders compared with the initial (prepartum) values. At the time of the ﬁ nal examination, there were no signiﬁ cant differences with the initial values. During all stages of the study, biomechanical disorders of the following regions were most characteristic for its participants: thoracic (structural component), lumbar (visceral and structural component), pelvis (visceral and structural component). In the control group, there was a statistically signiﬁ cant (p<0,05) increase in the detection frequency of somatic dysfunctions (SD) in the lumbar region (visceral component) after childbirth, compared with baseline indicators. After osteopathic correction in this group, the detection frequency of these disorders did not signiﬁ cantly differ from the initial values. In the main and control groups, a statistically signiﬁ cant (p<0,05) decrease in the detection frequency of SD in the pelvic region (structural component) was found after the correction, compared with the initial values. After childbirth, an increase in the amount of SD in the dura mater region was observed in the main group and the comparison group. During this period, there was a statistically signiﬁ cant (p<0,05) more frequent detection of dura mater SD in the main group compared with the control group. At the ﬁ nal examination, dura mater SD was detected in all groups almost as rarely as before childbirth.

Conclusion. The regional somatic dysfunctions of the thoracic, lumbar, and pelvic regions were the most characteristic for the examined puerperas. Postpartum women who received spinal anesthesia during childbirth are characterized by an increase in the detection frequency of global rhythmogenic cranial disorders and regional biomechanical disorders of the dura mater after childbirth. Postpartum women who did not receive spinal anesthesia during childbirth are characterized by an increase in the detection frequency of regional biomechanical disorders in the lumbar region (visceral component) after childbirth. After osteopathic correction, the frequency of detection of these disorders decreases almost to the baseline. Osteopathic correction is accompanied by a decrease in the detection frequency of disorders of the pelvic region (structural component) compared with the initial values, both in puerperas who received spinal anesthesia and in those who did not receive it.