{"id":1664,"date":"2023-12-12T11:27:48","date_gmt":"2023-12-12T09:27:48","guid":{"rendered":"https:\/\/www.fusioterapeutsandra.ee\/?p=1664"},"modified":"2023-12-12T11:37:10","modified_gmt":"2023-12-12T09:37:10","slug":"rasedus-ja-skolioos-5-muuti","status":"publish","type":"post","link":"https:\/\/fusioterapeutsandra.ee\/en\/rasedus-ja-skolioos-5-muuti\/","title":{"rendered":"Rasedus ja skolioos – 5 m\u00fc\u00fcti"},"content":{"rendered":"
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Raseduse ja skolioosiga seoses levib mitmeid m\u00fc\u00fcte, mida sooviksin \u00fcmber l\u00fckata v\u00f5i l\u00e4hemalt vaadata.\u00a0<\/span><\/h5>
Uuringuid sellel teemal leiab p\u00e4ris palju, kuid n\u00e4ib, et erinevaid tulemusi ja j\u00e4reldusi on sama palju kui uuringuid. Samuti on s\u00fcnnitusabi ja traditsioonid igas riigis erinevad ehk raske on j\u00e4reldusi teha, mis igas \u00fchiskonnas p\u00e4deks.\u00a0 <\/span>Viisin sel aastal ise v\u00e4ikese k\u00fcsitluse l\u00e4bi, mille tulemusi ka siin kajastan ja sealt saadud soovitusi ning muresid piltidel jagan. <\/span>Varem oskasin vaid loetu p\u00f5hjal soovitusi anda v\u00f5i kaasa m\u00f5elda v\u00f5ttes arvesse ka enda opereeritud skolioosiga kaasnevaid kogemusi. <\/span>S\u00fcgavam huvi teema vastu tekkis peale ise rasedaks j\u00e4\u00e4mist ning n\u00fc\u00fcd \u00fche p\u00f5nni emana.\u00a0<\/span><\/h5>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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M\u00fc\u00fct nr 1<\/h3>

Skolioosiga naised ei saa lapsi<\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Siin all m\u00f5eldakse tavaliselt raskusi lapse kandmisel v\u00f5i s\u00fcnnitamisel, mitte otseselt viljatust. H\u00e4guselt m\u00e4letan minagi lauset arsti suust, mis viitas, et<\/strong> tulevikus \u201csellise seljaga\u201d lapsi saada on raske<\/strong> v\u00f5i v\u00f5imatu. Olen seda mitmel korral ka oma klientidelt kuulnud. Tean lugusid, kus selliste v\u00e4lja\u00fctlemiste t\u00f5ttu on naised loobunud emaks saamisest v\u00f5i ebameeldiv lause on neil v\u00e4rskelt meeles ka mituk\u00fcmmend aastat hiljem. Ma ei oska isegi arvata, kust selline arusaam t\u00e4psemalt p\u00e4rineb – on see seotud potentsiaalselt v\u00e4henenud ruumiga k\u00f5hu\u00f5\u00f5nes? V\u00f5i arvatakse, et selja koormustaluvus on liialt v\u00e4ike lisaraskuse kandmiseks? <\/span><\/p>

Igal juhul nii see ei ole – skolioos ei ole laste saamisel takistuseks!<\/strong> Aastatel 1980<\/span>-2015 avaldatud 22 artiklit j\u00e4reldasid just seda (8). Loodetavasti j\u00f5uab selliseid (ja ka teisi!) v\u00e4\u00e4rasid s\u00f5numeid autoriteetsetelt spetsialistidelt aina v\u00e4hem noorte naisteni.<\/span><\/p>

Minu miniuuringus k\u00fcsisin laste arvu. Sellele k\u00fcsimusele vastas 9 naist, kellest kaks on s\u00fcnnitanud kolm last ja \u00fcks kaks last.\u00a0<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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M\u00fc\u00fct nr 2<\/span><\/h3>

Skolioosiga naised s\u00fcnnitavad keisril\u00f5ike abil<\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Uuringus, kus oli 116 naist leiti, et skolioos ei olnud keisril\u00f5ikega s\u00fcnnitamise eraldiseisvaks riskifaktoriks ega muudeks s\u00fcnnitusega seotud probleemides (3).<\/span><\/p>

Kui vaadata soomlaste uuringut, siis keisril\u00f5iget esines rohkem neil opereeritud skolioosiga naistel, kelle fiksatsioon ulatus neljanda nimmel\u00fclini ning opereeritud skolioosiga naistel kasutati keisril\u00f5iget rohkem kui skolioosita naistel (64% versus 33% vastavalt). Veidi rohkem keisril\u00f5ikeid (36.9% versus 28.2%) t\u00e4heldati opereeritud skolioosiga versus mitte opereeritud skolioosi puhul (9), kuid need numbrid j\u00e4\u00e4vad endiselt tavapopulatsiooniga samadesse suurusj\u00e4rkudesse.<\/strong> (2,9)\u00a0<\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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M\u00fc\u00fct nr 3<\/span><\/h3>

Skolioosiga naistel on rohkem seljavalu raseduse ajal ning s\u00fcnnituse j\u00e4rgselt<\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Arvan, et seda on v\u00e4ga raske adekvaatselt hinnata, et j\u00e4reldusi teha, sest faktoreid seljavaluks on v\u00e4ga palju. Samuti hinnanguid ja proaktiivsust seljavaluga tegelemise suunas. \u00dcle lahe tehtud uuringus, kus oli ka kontrollgrupp, leiti, et peale s\u00fcnnitust oli alaseljavalu esinemine naiste seas v\u00f5rdne (43% ja 42%), aga raseduse ajal skolioosiga naistel veidi suurem<\/strong> (48% versus 34%) (1).<\/span><\/p>

Minu 13 vastajaga \u201cminiuuringust\u201d, kus 5 naist on opereeritud seljaga, selgus, et <\/span>raseduse ajal hindasid oma seljaga seonduvaid probleeme kergeks kuni m\u00f5\u00f5dukaks 7 vastanut ja probleeme ei t\u00e4heldanud 5 vastajat. \u00dcks vastaja koges tugevaid probleeme seljaga. Kuid rasedusaegsetest seljaga seotud probleemidest arvas vaid \u00fcks vastaja, et seos skolioosiga on tugev ning enamus seost skolioosiga ei loonudki.<\/strong><\/span><\/p>

Eestis ei ole laialt levinud, kuid skolioosil\u00f5ikuseid tehakse ka eesmise v\u00f5i k\u00fclgmise l\u00e4henemisega. V\u00f5iks arvata, et ehk tagumine l\u00e4henemine, mis traumeerib seljalihaseid, suurendab seljavalu esinemist lumbaalosa skolioosiga s\u00fcnnitanud naistel, kuid ka see on \u00fcmber l\u00fckatud (4). <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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M\u00fc\u00fct nr 4<\/span><\/h3>

Skolioosiga naistele ei saa teha epiduraali ehk nn. seljas\u00fcsti<\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Kuna l\u00fclisammas ei ole skolioosi puhul sirge, siis tavap\u00e4rased epiduraali manustamise v\u00f5tted ei pruugi toimida ning eeldavad kogenud anestesioloogi. Samas, kirjandusest ei leia kinnitust, et skolioosi puhul epiduraali teha ei saa v\u00f5i et see eba\u00f5nnestuks rohkem kui tavapopulatsioonil.\u00a0<\/span><\/p>

N\u00e4iteks – 59 naisega\/84 s\u00fcnnitust uuringus leiti, et vaid \u00fchel korral 71-st ei saanud epiduraali teha ning kolmel korral anestesioloog keeldus<\/strong> (5). 163 naisega uuringus oli anesteesiaga probleem vaid kuuel protsendil skolioosiga naistest (9).\u00a0<\/span><\/p>

Minu l\u00e4biviidud v\u00e4ikeses k\u00fcsitluses<\/span> seitse vastajat kolmeteistk\u00fcmnest ei kasutanud epiduraali, 5 kasutas. \u00dckski vastajatest ei kirjeldanud eba\u00f5nnestunud epiduraali. <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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M\u00fc\u00fct nr 5<\/span><\/h3>

Rasedusega suureneb skolioos<\/span><\/h3>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t
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Seda \u201cm\u00fc\u00fcti\u201d pole ma palju kuulnud, kuid kirjanduses on seda uuritud ja pean oluliseks v\u00e4lja tuua. Sageli on uuringu valim v\u00e4ga v\u00e4ike, sest t\u00e4iskasvanueas ei k\u00e4ida tihti skolioosi j\u00e4lgimiseks r\u00f6ntgenis ja uuringu andmed p\u00e4rinevad nendelt naistelt, kes on juhuslikult enne ja peale rasedust r\u00f6ntgenis k\u00e4inud. Igal juhul – <\/strong><\/span>v\u00e4ikeseid suurenemisi Cobb nurgas raseduse j\u00e4rgselt on t\u00e4heldatud, aga nende olulisus v\u00f5i seos rasedusega on k\u00fcsitav (8,9) ning ei s\u00f5ltu skolioosi ravimeetodist<\/strong> (2). <\/span><\/p>

M\u00f5nes uuringus ei ole leitud mingeid muutuseid skolioosi suuruses (5). K<\/span>ui v\u00f5rrelda opereerimata ja opereeritud skolioosiga naisi, siis rasedus ei suurenda skolioosi suurust (6). Samuti ei leitud skolioosi suurenemist vaid konservatiivselt ravitud naiste seas (7).\u00a0 <\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Kokkuv\u00f5tvalt v\u00f5ib \u00f6elda, et skolioosiga naised saavad lapsi ning neil ei ole k\u00f5rgendatud riski rasedusaegseteks komplikatsioonideks<\/strong> (8). Samuti elukvaliteet ja seksuaalfunktsioon peale s\u00fcnnitust on v\u00f5rdne tavapopulatsiooniga (1). \u00dcldiselt oskavad arstid ja \u00e4mmaemandad n\u00f5ustada skolioosiga naist, kuid kindlasti vajaks see pool parandamist. Levinud on endiselt palju \u201cvanakooli\u201d suhtumist v\u00f5i teadmatust (minu isiklik kogemus n\u00e4iteks). Seet\u00f5ttu on hea ise k\u00fcsimusi k\u00fcsida ning mitte leppida pinnapealse vastusega – nii suuname ka spetsialisti t\u00e4psemaid vastuseid otsima.<\/span><\/p>

Hea oleks uurida eraldi ja laiemalt Eesti kogemust, et saada meie \u00fchiskonnas p\u00e4devad vastused. M\u00f5tted tulevikuks! <\/span>Seniks soovin, et kasv\u00f5i \u00fcks inimene siit kasulikku infot sai v\u00f5i v\u00e4henes m\u00f5ni hirm!<\/strong> Soovitan teha koost\u00f6\u00f6d spetsialistidega ning soovi korral v\u00f5ib otsida tuge ja n\u00f5u ka n\u00e4iteks Skolioos Eesti<\/a> grupist. <\/span><\/p>

Siia l\u00f5ppu ka mu “miniuuringus” osalejate soojad soovitused \ud83d\ude42<\/strong><\/span><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t

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Viidatud artiklid<\/p>

1- Grabala P, Helenius I, Buchowski JM, Larson AN, Shah SA. Back Pain and Outcomes of Pregnancy After Instrumented Spinal Fusion for Adolescent Idiopathic Scoliosis. World Neurosurg. 2019 Apr;124:e404-e410. doi: 10.1016\/j.wneu.2018.12.106. Epub 2019 Jan 3. PMID: 30610987. https:\/\/pubmed.ncbi.nlm.nih.gov\/30610987\/<\/a>\u00a0<\/p>

2- Theroux J, Brown BT, Marchese R, Selby M, Cope V, McAviney J, Beynon A. The impact of pregnancy on women with adolescent idiopathic scoliosis: a scoping review. Eur J Phys Rehabil Med. 2023 Aug;59(4):505-521. doi: 10.23736\/S1973-9087.23.08086-3. PMID: 37746783; PMC10548399. https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10548399\/<\/p>

3- Lebel DE, Sergienko R, Wiznitzer A, Velan GJ, Sheiner E. Mode of delivery and other pregnancy outcomes of patients with documented scoliosis. J Matern Fetal Neonatal Med. 2012 Jun;25(6):639-41. doi: 10.3109\/14767058.2011.598587. Epub 2011 Nov 9. PMID: 22070615. https:\/\/pubmed.ncbi.nlm.nih.gov\/22070615\/<\/a>\u00a0<\/p>

4- Cao Y, Shu S, Jing W, Zhu Z, Qiu Y, Bao H. Quality of Life During Pregnancy, Caesarean Section Rate, and Anesthesia in Women with a History of Anterior Correction Surgery for Lumbar Scoliosis: A Case-Control Study. Med Sci Monit. 2020 Oct 17;26:e926960. doi: 10.12659\/MSM.926960. PMID: 33067410; PMCID: PMC7577072. https:\/\/pubmed.ncbi.nlm.nih.gov\/33067410\/<\/a><\/p>

5 –\u00a0 Chan, E. W., Gannon, S. R., Shannon, C. N., Martus, J. E., Mencio, G. A., & Bonfield, C. M. (2017). The impact of curve severity on obstetric complications and regional anesthesia utilization in pregnant patients with adolescent idiopathic scoliosis: a preliminary analysis. Neurosurgical Focus FOC<\/i>, 43<\/i>(4), E4. https:\/\/doi.org\/10.3171\/2017.7.FOCUS17321<\/a> https:\/\/thejns.org\/focus\/view\/journals\/neurosurg-focus\/43\/4\/article-pE4.xml<\/a>\u00a0<\/p>

6- Pawel Grabala, Ilkka Helenius, Suken A. Shah, A. Noelle Larson, Jacob M. Buchowski, Michal Latalski, Michal Grabala, Tomasz Guszczyn. Impact of Pregnancy on Loss of Deformity Correction After Pedicle Screw Instrumentation for Adolescent Idiopathic Scoliosis, World Neurosurgery, Volume 139, 2020\u00a0 https:\/\/www.sciencedirect.com\/science\/article\/abs\/pii\/S1878875020306136?via%3Dihub<\/a>\u00a0<\/p>

7- Schroeder JE, Dettori JR, Ecker E, Kaplan L. Does pregnancy increase curve progression in women with scoliosis treated without surgery? Evid Based Spine Care J. 2011 Aug;2(3):43-50. doi: 10.1055\/s-0030-1267112. PMID: 23526896; PMCID: PMC3604750. https:\/\/pubmed.ncbi.nlm.nih.gov\/23526896\/<\/a>\u00a0<\/p>

8- Dewan MC, Mummareddy N, Bonfield C. The influence of pregnancy on women with adolescent idiopathic scoliosis. Eur Spine J. 2018 Feb;27(2):253-263. doi: 10.1007\/s00586-017-5203-7. Epub 2017 Jun 29. PMID: 28664223. https:\/\/link.springer.com\/article\/10.1007\/s00586-017-5203-7<\/a>\u00a0<\/p>

9- Nandoliya KR, Sadagopan NS, Alwakeal A, Kemeny H, Cloney M, Dahdaleh NS, Koski T, El Tecle N. Adolescent Idiopathic Scoliosis and Pregnancy. Cureus. 2023 Oct 10;15(10):e46782. doi: 10.7759\/cureus.46782. PMID: 37954752; PMCID: PMC10633849.https:\/\/www.ncbi.nlm.nih.gov\/pmc\/articles\/PMC10633849\/<\/a><\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t<\/section>\n\t\t\t\t<\/div>","protected":false},"excerpt":{"rendered":"

Raseduse ja skolioosiga seoses levib mitmeid m\u00fc\u00fcte, mida sooviksin \u00fcmber l\u00fckata v\u00f5i l\u00e4hemalt vaadata.\u00a0 Uuringuid sellel teemal leiab p\u00e4ris palju, kuid n\u00e4ib, et erinevaid tulemusi ja j\u00e4reldusi on sama palju kui uuringuid. Samuti on s\u00fcnnitusabi ja traditsioonid igas riigis erinevad ehk raske on j\u00e4reldusi teha, mis igas \u00fchiskonnas p\u00e4deks.\u00a0 Viisin sel aastal ise v\u00e4ikese k\u00fcsitluse …<\/p>\n

Rasedus ja skolioos – 5 m\u00fc\u00fcti<\/span> Read More »<\/a><\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"","site-content-layout":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-1664","post","type-post","status-publish","format-standard","hentry","category-uncategorized"],"yoast_head":"\nRasedus ja skolioos - 5 m\u00fc\u00fcti • F\u00fcsioterapeut Sandra Joa<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/fusioterapeutsandra.ee\/en\/rasedus-ja-skolioos-5-muuti\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Rasedus ja skolioos - 5 m\u00fc\u00fcti • F\u00fcsioterapeut Sandra Joa\" \/>\n<meta property=\"og:description\" content=\"Raseduse ja skolioosiga seoses levib mitmeid m\u00fc\u00fcte, mida sooviksin \u00fcmber l\u00fckata v\u00f5i l\u00e4hemalt vaadata.\u00a0 Uuringuid sellel teemal leiab p\u00e4ris palju, kuid n\u00e4ib, et erinevaid tulemusi ja j\u00e4reldusi on sama palju kui uuringuid. 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