Chronic Pain Management in Pregnancy: A Review of the Literature
April Jankiewicz, RN, BHSc(Hon), Andrea Fielder BSc, PhD, and Jane Warland, RN, RM, PhD
Objective: This review summarizes current literature and explores issues involved in the management of pregnant women with chronic pain conditions. Methods: Articles in this review were selected through searches of Scopus, Cumulative Index of Nursing and Allied Health Literature (CINAHL), Cochrane Library, and MEDLINE databases. “Grey” literature such as cross-references from identified articles, clinical recommendations, professional consensus, bibliographies from review articles, and book chapters were also examined for appropriate material.
Results: The search yielded 18,401 results in total; however, the majority related to management of labour pain, physiological pain in pregnancy, chronic pain in the nonpregnant population, and opioid maintenance in pregnancy for substancedependent women. These results were therefore excluded. Sixteen relevant articles were included. A lack of high-quality research in the area, a potential for increased maternal and fetal complications, and the need for multidisciplinary input were identified as issues.
Discussion: This is one of the first literature reviews to assess the management of women with chronic pain conditions who become pregnant. Poorly managed chronic pain can have adverse effects on the mother and lead to premature induction of labour and birth of the infant. Despite the apparent risks, there remains an absence of research in this field.
Conclusion: It is imperative that research and clinical education are continued in this field. This will enable health care clinicians to provide women with appropriate, evidence-based options for their prenatal care, as well as effective, ongoing management of chronic pain conditions during pregnancy.
women, chronic pain, pregnancy
This article has been peer reviewed.