Ultrasonography for carpal tunnel syndrome in pregnancy: A prospective
cross-sectional study
Abstract
Objective: To analyze the ultrasonography (USG) values of median nerve
cross sectional area (MN-CSA) in pregnant women with and without
clinically diagnosed carpal tunnel syndrome (CTS). Design: Prospective
cross-sectional study. Setting: Third trimester pregnant women during
their routine office visits. Methods: USG was performed by a
perinatologist and the MN-CSA at the carpal tunnel inlet was measured.
Then, the participants were asked about the presence of typical CTS
symptoms. Participants with typical clinical symptoms were assigned to
the CTS group. Remaining participants were assigned to the Control
group. Main outcome measures: The groups were compared according to
MN-CSA. Results: Of the 89 pregnant women, 25 participants were grouped
in CTS group and the remaining 64 participants were grouped in Control
group. The MN-CSA was higher in the CTS group (9.44 ± 2.68) than in the
Control group (7.20 ± 1.99), p = 0.00004. There was a statistically
significant linear trend, p = 0.003, with higher MN-CSA associated with
a higher proportion of patients diagnosed as CTS. Conclusions: USG
measurement of MN-CSA at the wrist appears as a convenient method to
confirm CTS diagnosis in pregnant women. Further research is necessary
to determine a clear cut-off value for MN-CSA. Obstetricians can measure
MN-CSA to confirm CTS diagnosis and consequently can offer conservative
management, which is the widely accepted treatment modality in this
cohort.