Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study

<i>Background and Objectives</i>: Ankylosing spondylitis (AS) is a chronic progressive inflammatory process of the axial skeleton and sacroiliac joints (SIJ). Symptoms typically appear between the ages of 20 and 40, although there are also cases of juvenile-onset AS. This suggests that m...

Full description

Saved in:
Bibliographic Details
Main Authors: Sakine Rahimli Ocakoglu, Alper Vatansever, Zeliha Atak, Nurefsan Yanardag, Belkis Nihan Coskun, Sinem Akselim, Gokhan Ocakoglu
Format: Article
Language:English
Published: MDPI AG 2024-12-01
Series:Medicina
Subjects:
Online Access:https://www.mdpi.com/1648-9144/61/1/39
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832588001439383552
author Sakine Rahimli Ocakoglu
Alper Vatansever
Zeliha Atak
Nurefsan Yanardag
Belkis Nihan Coskun
Sinem Akselim
Gokhan Ocakoglu
author_facet Sakine Rahimli Ocakoglu
Alper Vatansever
Zeliha Atak
Nurefsan Yanardag
Belkis Nihan Coskun
Sinem Akselim
Gokhan Ocakoglu
author_sort Sakine Rahimli Ocakoglu
collection DOAJ
description <i>Background and Objectives</i>: Ankylosing spondylitis (AS) is a chronic progressive inflammatory process of the axial skeleton and sacroiliac joints (SIJ). Symptoms typically appear between the ages of 20 and 40, although there are also cases of juvenile-onset AS. This suggests that most patients with AS are of reproductive age at the time of diagnosis. The study aimed to identify differences in the shape of the sacroiliac joint depending on the type of birth (vaginal delivery (V/D) and the cesarean section(C/S) in patients with ankylosing spondylitis. <i>Materials and Methods</i>: On pelvis X-ray images of women n = 36 with AS and n = 34 in the control group, 12 landmarks were marked, and differences in SIJ shape between the study groups were assessed using generalized Procrustes Analysis. <i>Results</i>: The results showed that the anterior point of the SIJ had an enlarged shape in the V/D group compared with the C/S group, even in the control group. There was a difference between the mean right and left SIJ shapes of the AS group patients with V/D and the controls with C/S (<i>p</i> = 0.007 and <i>p</i> < 0.001). The superior part of the right SIJ tended to be enlarged in V/D-delivered AS patients, compared to the C/S control group. On the left side, the middle region of the SIJ was statistically enlarged in AS patients with V/D compared to the healthy C/S group. <i>Conclusions</i>: This study demonstrates that vaginal delivery is associated with increased sacroiliac joint (SIJ) enlargement in both healthy individuals and those with ankylosing spondylitis (AS). Our findings suggest that delivery type independently influences SIJ morphology, and cesarean section (C/S) may serve as a protective procedure for preserving SIJ shape in AS patients. These results underline the importance of individualized obstetric planning for AS patients to mitigate potential risks to SIJ morphology.
format Article
id doaj-art-8474c1b4ac9440b9bfdd78180b10a616
institution Kabale University
issn 1010-660X
1648-9144
language English
publishDate 2024-12-01
publisher MDPI AG
record_format Article
series Medicina
spelling doaj-art-8474c1b4ac9440b9bfdd78180b10a6162025-01-24T13:40:20ZengMDPI AGMedicina1010-660X1648-91442024-12-016113910.3390/medicina61010039Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective StudySakine Rahimli Ocakoglu0Alper Vatansever1Zeliha Atak2Nurefsan Yanardag3Belkis Nihan Coskun4Sinem Akselim5Gokhan Ocakoglu6Department of Obstetrics and Gynecology, Bursa City Hospital, 16110 Bursa, TurkeyDepartment of Anatomy, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, TurkeyDepartment of Obstetrics and Gynecology, Bursa City Hospital, 16110 Bursa, TurkeyDepartment of Obstetrics and Gynecology, Bursa City Hospital, 16110 Bursa, TurkeyDepartment of Rheumatology, Faculty of Medicine, Uludag University, 16059 Bursa, TurkeyDepartment of Physical Medicine and Rehabilitation, Bursa City Hospital, 16110 Bursa, TurkeyDepartment of Biostatistics, Faculty of Medicine, Bursa Uludag University, 16059 Bursa, Turkey<i>Background and Objectives</i>: Ankylosing spondylitis (AS) is a chronic progressive inflammatory process of the axial skeleton and sacroiliac joints (SIJ). Symptoms typically appear between the ages of 20 and 40, although there are also cases of juvenile-onset AS. This suggests that most patients with AS are of reproductive age at the time of diagnosis. The study aimed to identify differences in the shape of the sacroiliac joint depending on the type of birth (vaginal delivery (V/D) and the cesarean section(C/S) in patients with ankylosing spondylitis. <i>Materials and Methods</i>: On pelvis X-ray images of women n = 36 with AS and n = 34 in the control group, 12 landmarks were marked, and differences in SIJ shape between the study groups were assessed using generalized Procrustes Analysis. <i>Results</i>: The results showed that the anterior point of the SIJ had an enlarged shape in the V/D group compared with the C/S group, even in the control group. There was a difference between the mean right and left SIJ shapes of the AS group patients with V/D and the controls with C/S (<i>p</i> = 0.007 and <i>p</i> < 0.001). The superior part of the right SIJ tended to be enlarged in V/D-delivered AS patients, compared to the C/S control group. On the left side, the middle region of the SIJ was statistically enlarged in AS patients with V/D compared to the healthy C/S group. <i>Conclusions</i>: This study demonstrates that vaginal delivery is associated with increased sacroiliac joint (SIJ) enlargement in both healthy individuals and those with ankylosing spondylitis (AS). Our findings suggest that delivery type independently influences SIJ morphology, and cesarean section (C/S) may serve as a protective procedure for preserving SIJ shape in AS patients. These results underline the importance of individualized obstetric planning for AS patients to mitigate potential risks to SIJ morphology.https://www.mdpi.com/1648-9144/61/1/39ankylosing spondylitisstatistical shape analysissacroiliac jointcaesarian sectionvaginal deliveryanatomical changes
spellingShingle Sakine Rahimli Ocakoglu
Alper Vatansever
Zeliha Atak
Nurefsan Yanardag
Belkis Nihan Coskun
Sinem Akselim
Gokhan Ocakoglu
Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study
Medicina
ankylosing spondylitis
statistical shape analysis
sacroiliac joint
caesarian section
vaginal delivery
anatomical changes
title Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study
title_full Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study
title_fullStr Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study
title_full_unstemmed Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study
title_short Evaluation of Sacroiliac Joint Shape in Women with Ankylosing Spondylitis According to Mode of Birth Delivery: A Retrospective Study
title_sort evaluation of sacroiliac joint shape in women with ankylosing spondylitis according to mode of birth delivery a retrospective study
topic ankylosing spondylitis
statistical shape analysis
sacroiliac joint
caesarian section
vaginal delivery
anatomical changes
url https://www.mdpi.com/1648-9144/61/1/39
work_keys_str_mv AT sakinerahimliocakoglu evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy
AT alpervatansever evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy
AT zelihaatak evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy
AT nurefsanyanardag evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy
AT belkisnihancoskun evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy
AT sinemakselim evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy
AT gokhanocakoglu evaluationofsacroiliacjointshapeinwomenwithankylosingspondylitisaccordingtomodeofbirthdeliveryaretrospectivestudy