Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
High Prevalence of Fibromyalgia Symptoms Among Healthy Full Term Pregnant.
Saad, Sharon, Many, Ariel, Jacob, Giris, Ablin, Jacob N.
Fibromyalgia (FMS), a syndrome characterized by centrally mediated pain, tenderness and fatigue, is more prevalent among females compared with males. The impact of fibromyalgia on the course of pregnancy is not clearly defined. In the current stud we have evaluated the frequency of FMS symptoms among full term healthy pregnant women and the impact of such symptoms on the course of delivery.
After signing informed consent, participants (N=57) were interviewed and filled out questionnaires. The 2011 modification of the ACR 2010 criteria for the diagnosis of fibromyalgia was used. In addition, participants filled out the Fibromyalgia Impact Questionnaire (FIQ) and the SF-36 and the AIMS questionnaires. Manual dolorimetry was performed using a standard manual dolorimeter, in order to document the 1990 ACR criteria. After delivery, data was collected from the obstetric files relating to the course of the delivery. This data Included documenting the implementation of induction, the length (In minutes) of stage 1,2 and 3 of delivery, the implementation of epidural anesthesia, the need for artificial rupture of membranes (AROM), instrumental delivery and cesarean section. A VAS scale recording pain intensity during delivery was also documented. The study was conducted as an open label, observational research. The setting of the study was the Obstetric clinic of the Tel Aviv Sourasky medical center. Participants were pregnant women attending the obstetric clinic for routine evaluation before birth. This evaluation is generally conducted at week 38 of pregnancy. High risk pregnancies were excluded.
Out of 57 women recruited, 14 (24.6%) fulfilled Modified FMS criteria. This result did not correlate with the 1990 criteria, since none of these individuals fulfilled ACR 1990 criteria. The mean FIQ was 38.5 (SD- 14.5) and the men SF-36 (general health) was 82.3 (SD- 14.2). The mean SF-36 pain was 63.2 (SD- 22.8). A significant negative correlation was observed between the length of stage 3 of delivery and the SF-36 for social functioning (Pearson correlation -0.36, p<0.05). The VAS scale of pain during delivery was significantly positively correlated with the SF-36 pain recorded on the examination before delivery (Pearson correlation 0.482, p=0.05). Among women not fulfilling FMS criteria, 69.8% required epidural anesthesia. The corresponding figure among individuals fulfilling FMS criteria was 100%.
FMS symptoms were found to be highly prevalent among healthy pregnant women at term. The presence of such symptoms on evaluation before delivery correlated with the severity of pain during delivery and may have an impact on the course of delivery and the need for anesthesia. Evaluating for features of centrally mediated pain may be of clinical relevance for physicians involved in the treatment of pregnant women as well as for obstetricians.
To cite this abstract, please use the following information:
Saad, Sharon, Many, Ariel, Jacob, Giris, Ablin, Jacob N.; High Prevalence of Fibromyalgia Symptoms Among Healthy Full Term Pregnant. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :936