Estimating Pelvic Tilt in Post-Cesarean Women After the Puerperium: A Comparative Study With Non-Pregnant Women

Background: Passing from the first to the third trimester of pregnancy is correlated with a significant increase in pelvic anterior tilting that relates to lumbopelvic morbidities. Additionally, cesarean section (CS) is linked to lumbopelvic morbidities. This study measured the pelvic tilt angle and pelvic torsion in postpartum women who underwent CS after the end of the puerperium. The aim was to determine whether these kinematic pelvic measures persist or are corrected by the end of the puerperium. Therefore, the study compared these measures to those of the control group that had never been pregnant. Methods: This study followed the Strengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines for the cross-sectional comparative design, with retrospective classification of exposure (CS vs. nulliparous controls), in which 42 women were categorized into two equal-sized groups. Group (A) was 21 women who delivered by CS. Group (B) was 21 women who served as controls, who never experienced pregnancy. Women in the CS group were measured at 6–12 weeks postpartum. The digital pelvic inclinometer (DPI) was used to estimate the pelvic tilt angle. Results: The statistical analysis yielded non-significant differences between both groups in the right and left pelvic tilt angles (p = 0.385 and 0.762), respectively. Also, there was a non-significant difference in pelvic torsion between the two groups (p = 0.519). An analysis of covariance (ANCOVA) model adjusting for multiple physical covariates confirmed that the group differences in pelvic tilt and pelvic torsion remained non-significant. Conclusions: By 8 weeks postpartum, pelvic tilt and torsion in post-CS women return to near-normal levels, with residual differences that are negligible both statistically and clinically compared with the controls. Clinical Trial Registration: The study has been registered on https://clinicaltrials.gov/ (registration number: NCT06019962; registration link: https://clinicaltrials.gov/study/NCT06019962?cond=NCT06019962&rank=1).