Craniosacral rhythm in dorsopathy of pregnant women

• Elena V. Radzinskaya
• Vladislavа A. Novikovа

Abstract

The aim of the study was to establish a relationship between the parameters formed in the progress of pregnancy and the cranial rhythmic impulse (CRI) at the onset of lumbar pelvic pain.

Material and methods. A prospective cohort study was performed in 2019–2022 at the City Clinical Hospital No. 29 named after N.E. Bauman and the medical center “A Medclinic”. 171 pregnant women took part in the study. The patients were divided into 2 clinical groups: control group with a physiological course of pregnancy (n=84) and main group with dorsopathy (n=87), subsequently divided into two subgroups: 48 women with lower back pain (LBP), 39 with pelvic girdle pain (PGP).

Results. The neuro-orthopedic feature of the lumbar pain debut is a lower index of CRI in comparison with patients without lumbar pain: Me=7 cycles/min (Q1–Q3=6–8) versus Me=8 cycles/min in patients without lumbar pain (Q1–Q3=7–9) (p=0.001). CRI does not significantly correlate with the gestation period at the onset of lumbar pain, but demonstrates variability in dorsopathy (LBP or PGP) or in its absence: its values were significantly higher in patients with PGP compared with LBP (Me=8, Q1–Q3=6–8 cycles/min versus Me=7, cycles/min, Q1–Q3=6–8; p=0.04).

In pregnant women with the onset of lumbar pain or its absence, uterine-fetal-placental parameters significantly differ in combination with craniosacral rhythm: amniotic fluid index, placenta localization in the uterus, distance from the lower edge of the placenta to the internal os, cervical length, fetal weight and position at the time of onset of pain, total duration of gestagen intake and their daily dose: the “safe” time interval for taking progestogens/progesterone analogues during pregnancy, in which the onset of lumbar pain is unlikely (5 weeks or less). Taking progestogens/progesterone analogues for 5–16 weeks turned out to be more threatening for the development of LBP, and the interval >16 weeks – for PGP.

Conclusion. CRI is an extremely variable parameter that serves as an indicator of global rhythmogenic/hydrodynamic disorders of the body. It reflects the state of liquor dynamics, hemodynamic, and lymphodynamic processes occurring during gestation. The study demonstrated the relationship of CRI with utero-fetal-placental parameters, corresponding to the time of onset of dorsal pain in pregnant women of a specific location (LBP and PGP), which allows considering CRI as a potential marker of the functional capacity of hemodynamics, lymphodynamics, and cerebrospinal fluid dynamics during pregnancy in principle and during its complications (for example lumbar pelvic pain), to choose the direction of treatment measures.

Keywords: pregnancy; dorsopathy; lumbar pain; cranial rhythmic impulse; craniosacral rhythm; progesterone; classification trees

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