Symptomatology of carpal tunnel syndrome during pregnancy and puerperium

Objectives: Epidemiology of the carpal tunnel syndrome (CTS) during pregnancy remains to be fully elucidated. The purpose of the following study is to determine occurrence of that complication in a population of pregnant women. So far, the literature in Polish lacks information that might enable adequate diagnosis and proper therapy. Material and methods: The study included 301 women who delivered at term (between 37 and 41 weeks of pregnancy) at the Gynecological and Obstetrical University Hospital in Poznan. An original questionnaire about CTS symptoms was prepared for the purpose of the study. The tool included questions about general health, current and previous pregnancies, CTS symptoms, as well as the Boston Carpal Tunnel Questionnaire (BCTQ), modified for the purpose of the study. The original BCTQ includes questions about symptoms frequency during the last 2 weeks, while in our modified BCTQ we asked about symptoms during the whole pregnancy. The respondents filled in the questionnaire with the help of a physician. A part of the research group underwent Phalen sign evaluation. Results: Ninety-eight patients (32.6%) reported occurrence of at least one CTS symptom during pregnancy and 22 patients (22.4%) had similar symptoms in previous pregnancies. Only 3 patients had received any form of therapy. The number of patients with CTS symptoms who reported extremities edema was significantly higher than in the group without CTS symptoms (26.3% vs. 6.1%; p<0.05). The frequency of occurrence of diabetes and pregnancy induced hypertension was similar in both groups. The results of the first part of the modified BCTQ (symptom severity) were significantly higher in the CTS group as compared to non-CTS group (2.1±0,8 vs. 1.0±0.1; p<0.05). The results of the second part of the modified BCTQ (impairment of daily life activities) were similar (1.7±0.8 vs. 1.0±0.1; p<0.05). Out of 74 patients with CTS symptoms who underwent Phalen sign examination, 50% had positive Phalen sign. Patients with positive Phalen sign had significantly higher scores for both parts of the modified BCTQ. Conclusions: CTS symptoms are quite common during pregnancy (32% in the study group). However, symptom intensity remains rather moderate. Some of the patients had those symptoms during previous pregnancies. Although the frequency of CTS symptoms is quite high in the population of pregnant women, only few have any form of treatment. Early detection of CTS symptoms in pregnant women is very important, because it allows introduction of conservative treatment, which is successful in most cases.