Low Back Pain and ICP in Pregnancy

Study Notes

Low Back Pain in Pregnancy

Common benign condition, often appearing in the third trimester.
Characterized by radiating thigh pain, worsening with activity, and relieving with rest.
Caused by exaggerated lordosis (curve in the lower back) from an enlarging uterus, weakened abdominal muscles, and joint/ligament laxity.
Risk factors include previous pregnancies (multiparity), prior back pain, and significant weight gain.
Crucial to rule out preterm labor or pyelonephritis (kidney infection).
Reassurance and conservative management are typically sufficient, including behavioral modifications (supportive shoes, massage, firm mattress), and analgesics.

Intrahepatic Cholestasis of Pregnancy (ICP)

Occurs during the third trimester due to increased estrogen and progesterone causing stasis in the liver's bile ducts and impairing bile flow.
Leads to elevated bile acids in the liver and skin, resulting in itching (pruritus), especially on hands and feet.
Elevated liver enzymes (aminotransferases) and bilirubin levels also occur.
Risk factors include prior ICP, maternal age over 35, and multiple pregnancies.
Bile acids can cross the placenta, posing fetal risks; the higher the maternal bile acid levels, the greater the fetal risk.
Potential for Intrauterine Fetal Death (IUFD) exists.
Management involves ursodeoxycholic acid (to lower bile acid levels), frequent monitoring of the mother and fetus, and delivery by 37 weeks.

Description

This quiz explores common conditions that can affect pregnant women, focusing on low back pain and intrahepatic cholestasis of pregnancy (ICP). Learn about the causes, risk factors, symptoms, and management strategies for these issues. Understanding these conditions is crucial for expectant mothers and healthcare providers.