BMJ 1996;313:755 (21 September)

Letters

Long term backache after childbirth

Potential confounding by obstetric malposition was not considered

EDITOR,--Epidural analgesia forms an important part of the clinical management of labour. Robin Russell and colleagues' study showing a lack of association between epidural analgesia during labour and the development of new backache after childbirth should prove reassuring to clinicians and prospective parents alike.1

The authors do not, however, seem to have considered the potential confounding effect of obstetric malposition, in particular the occipitoposterior position, in both pregnancy and labour. It has been estimated that at least a fifth of women start labour with the fetal head in the occipitoposterior position.2 This malposition can cause severe back pain both in labour and in the later stages of pregnancy. The occipitoposterior position is recognised as a common cause of prolonged and dysfunctional labour. Certain pelvic shapes seem to predispose to a recurrence of this malposition in subsequent pregnancies.

Pregnant women whose fetus remains . . . [Full text of this article]


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Relevant Article

Long term backache after childbirth: prospective search for causative factors
Robin Russell, Ruth Dundas, and Felicity Reynolds
BMJ 1996 312: 1384-1388. [Abstract] [Full Text]

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