Ultrasonographic Measurement of Mean Cross-sectional Area of the Median Nerve in Pregnant Women in a Tertiary Level Hospital of Nepal: A Descriptive Cross-sectional Study (original) (raw)
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Ultrasound elastographic evaluation ofthe median nerve in pregnant women with carpal tunnel syndrome
To evaluate the median nerve (MN) in pregnant women with carpal tunnel syndrome (CTS) by using ultrasound elastography. 30 wrists of 20 pregnant women with CTS and 25 wrists of 14 healthy control pregnant women were evaluated by ultrasound and ultrasound elastography (UE). The MN in the patients' wrist was imaged to measure the cross-sectional area and longitudinally to calculate the elasticity value (EV) at four different locations (proximal carpal tunnel (CT) at the level of the pisiform, distal CT at the level of the hamate, middle of the CT and forearm at one centimeter above the CT). Clinical classification was performed according to a historic and objective scale of CTS. In the healthy pregnant women and pregnant women with CTS, MN area and EV were analyzed statistically by comparing with parity and clinical grade. RESULTS:There was a statistically significant difference for MN area between the patient and control groups (p = 0.001). A positive relationship was found betwe...
2021
The objective of this study is to determine whether the cross sectional area (CSA) measurement of the median nerve at the wrist differ between carpal tunnel syndrome (CTS) in diabetic patients with and without diabetic polyneuropathy (DPN). This study included 44 patients with type II diabete millitus (DM) with CTS, 32 patients with CTS and DPN, 46 patients with idiopathic CTS, and 42 healthy subjects. Ultrasonographic measurement of the CSA of the median nerve was made at the level of the wrist, together with nerve conduction studies. The median CSA at the wrist was significantly larger in all patient groups compared with healthy subjects. The median nerve CSA was significantly larger in diabetic patients with CTS than patients with idiopathic CTS. The median nerve CSA at wrist was significantly smaller in patients with CTS and DPN compared with diabetic patients with CTS only. The median nerve CSA at the wrist was larger in diabetic patients with CTS than patients with idiopathic CTS and CTS with DPN. Median nerve CSA can help to differentiate between diabetic patients with CTS with and without DPN. Abbreviations: CSA = cross-sectional area, CTS = carpal tunnel syndrome, DM = diabetis mellitus, DPN = diabetic polyneuropathy.
Median and ulnar nerve conduction in pregnancy
International Journal of Gynecology & Obstetrics, 2004
Objective: A prospective, observational study assessed median and ulnar nerve conduction during pregnancy, to identify the optimum test for differentiating physiological effects of pregnancy from pathological carpal tunnel syndrome (CTS). Methods: Pregnant women (n=18) and age-and parity-matched non-pregnant controls (n=13) were recruited. Symptomatic and neurophysiological evaluations were performed. Median and ulnar nerve latencies and intrapalmar latency (difference between median and ulnar nerve latencies) were computed. Results: Median nerve distal latency is more prolonged in pregnant women compared with non-pregnant controls. Median nerve latency is more prolonged in pregnant women with symptoms of CTS than in asymptomatic women. The difference between median and ulnar nerve conduction (normal b0.2 ms) discriminates well between symptomatic and asymptomatic pregnant women. Conclusions: Intrapalmar latency is proposed as a useful diagnostic test for classification of carpal tunnel syndrome during pregnancy.
Ultrasonographic Assessment of Median Nerve Cross-Sectional Area in Obstetricians
Ankara city hospital medical journal, 2024
Introductıon: : We aimed to investigate whether the median nerve cross-sectional area (MNCSA) is affected in obstetricians due to occupational reasons Methods: In this cross-sectional study, 93 participants were included. The median nerve cross-sectional area was measured by high-resolution ultrasonography, and clinical symptoms of carpal tunnel syndrome were questioned. The measurements of MNCSA for the right hand were higher in ≥ 8 years of working experience than in < 8 years of working experience (11mm2 vs. 8 mm2, p<0.001). A significant positive moderate correlation was also between right MNCSA and working experience and daily ultrasonography practice (r=0.557; p<0.001, r=0.561; p<0.001, respectively). This study showed that increased MNCSA was associated with obstetricians' working experience and daily ultrasonography practice. Considering the prevalence of carpal tunnel syndrome in specific occupational groups, MNCSA measurement by ultrasound may contribute to early diagnosis and convenient selection for further diagnostic tests.
Clinical Evaluation of the Treatment of Carpal Tunnel Syndrome Conservatively in Pregnant Women
2019
Original Research Article Background: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. It is more common in the middle age group and more common in women than men. Several factors cause CTS, including pregnancy and lactation. Very few studies have been conducted regarding the treatment of CTS in Bangladesh. So the local data related to the issue are very limited. Aim of study: The aim of the study was to evaluate of carpal tunnel syndrome conservatively in pregnant women. Methods: This was an observational prospective study. The study was conducted in the Department of Orthopedics of Shaheed M. Monsur Ali Medical College, Sirajganj, Bangladesh during the period from January 2017 to December 2018. In total 60 pregnant women with carpal tunnel syndrome was the study population. Patients were classified into mild, moderate and severe carpal tunnel syndrome according to clinical and nerve conduction grading. Results: Based on clinical assessment, 56.67% had mild to...
Prevalence of Carpel Tunnel Syndrome among Pregnant Women in Lahore City
2020
Carpal Tunnel Syndrome (CTS) is one of the most common neuropathies and pregnancy is a risk factor of CTS. The frequency of CTS during pregnancy, especially that according to the gestational age, is not well determined, and here we attempted to determine it in three hospitals in Lahore, Pakistan. By the use of non-probability purposive sampling method, 286 samples of pregnant females were collected. The diagnosis of CTS was made using Phalens test and others. Phalen test was positive in 20.8, 29.6, and 45.3% during 1 st , 2 nd and 3 rd trimester, respectively. The questionnaire data indicated that CTS was present in 11.2, 37.0 and 49.5% in 1 st , 2 nd and 3 rd trimester, respectively. Swelling of the joint was observed in 31.6, 51.9 and 77.8% in 1, 2 and 3 trimester, respectively. The same tendency of the occurrence of CTS according to the three trimesters was observed when using nerve compression test or Tinels test.
Frequency of Local Treatment in Carpal Tunnel Syndrome during Pregnancy
Pakistan Journal of Medical and Health Sciences, 2021
Background and Aim: The most common entrapment neuropathy is carpal tunnel syndrome (CTS). Carpal tunnel syndrome is caused by median nerve compression at the wrist joint. Idiopathic carpal tunnel syndrome is the most common cause. Among the other physiologic causes of carpal tunnel syndrome (wrist trauma, diabetes, hypothyroidism, rheumatoid arthritis, occupation, contraception, and pregnancy), pregnancy is the most common. The objective of the present study was to determine the frequency of local treatment in carpal tunnel syndrome during pregnancy. Materials and Methods: This cross-sectional study was carried out on 45 pregnant women with carpal tunnel syndrome in the departments of Neurology and Gynaecology, Ayub Teaching Hospital, Abbottabad from May 2020 to April 2021. Individuals who met the inclusioncriteria were enrolled in this study. Ethical approval and consent forms were taken from the participants. All the patients were treated with local treatment (dexamethasone aceta...
Multicenter study on carpal tunnel syndrome and pregnancy incidence and natural course
Acta Neurochirurgica
Objective. To evaluate the incidence of carpal tunnel syndrome (CTS) in pregnancy through a validated and multiperspective assessment of CTS and to assess the course of carpal tunnel syndrome after pregnancy. Methods. During 2000-2001, the Italian CTS study group in 7 Italian centers studied the occurrence of CTS in women during the last period of pregnancy. The group enrolled and followed-up (10-15 months) 63 women during and after pregnancy with multiple measurements of CTS. In addition to the physician-centered and neurophysiologic traditional evaluations, a validated patientoriented measurement to obtain more comprehensive and consistent data for severity of symptoms and functional impairment was adopted. Results. CTS was clinically diagnosed in more than half of women (62%). Neurophysiological evaluation provided diagnosis of CTS in around half of women (43% were positive in one hand at least). Comparison of baseline and follow-up data showed a significant spontaneous improvement of patient-oriented and neurophysiologic measurements. Nevertheless, about half of women with CTS during pregnancy still complained of CTS symptoms one year after delivery. Conclusions. Our observations confirmed the frequent occurrence of CTS in pregnancy. At follow-up we observed that most CTS cases improve spontaneously without treatment but only in half of women CTS symptoms disappeared one year after delivery.
Carpal Tunnel Syndrome and Its Prevalence in Pregnant Females of Faisalabad Pakistan
2018
Carpal Tunnel Syndrome is symptomatic compression neuropathy of the median nerve at the level of the wrist. This syndrome is the second highly frequent musculoskeletal disorder, followed by a back pain. To find out the prevalence of pregnancy-related carpal tunnel syndrome, data was collected from the DHQ and Allied hospitals of Faisalabad with the help of Boston carpal Tunnel questionnaire modified according to studies. Total 300 patients were assessed by taking the history of sign and symptoms and provocative physical tests. Among them 103 patients showed all the symptoms and tests positive, these diagnosed patients were then asked to fill out a questionnaire to check the severity of their symptoms and functional limitations. Data was collected and analyzed by SPSS-23. Results have shown that the prevalence of PRCTS is 34.3%. Multigravida women 72.8 % shows more occurrence than that of primigravid which is 27.2 %. On the numeric pain rating scale, most patients reported severe pai...