Abstract
Background
During spontaneous vaginal delivery, pubic symphyseal widening is normal. Common changes
are reversible after complication-free birth. However, cases of peripartum symphysis
separation are rare. There is no consensus in the literature on how to treat pregnancy-related
pubic symphysis separation.
Methods
This review used a literature-based search (PubMed, 1900–2013) and analysis of 2 own
case reports. Studies with conclusions regarding management were particularly considered.
Results
Characteristic symptoms, suprapubic pain and tenderness radiating to the posterior
pelvic girdle or lower back, may be noted 48 h after delivery. Pain on movement, especially walking or climbing stairs, is often
present. Conservative treatments, such as a pelvic brace with physiotherapy and local
interventions such as infiltration, are successful in most cases. Symptom reduction
within 6 weeks is the most common outcome, but can take up to 6 months in some cases.
Surgical intervention is needed in cases of persistent separation. Anterior plate
fixation is offered as a well-known and safe procedure. Minimally invasive SI joint
screw fixation is required in cases of combined posterior pelvic girdle lesions.
Summary
Postpartum symphyseal rupture can be indicated with the rare occurrence of pelvic
pain post-delivery, with sciatica or lumbago and decreased mobility. The diagnosis
is made on clinical findings, as well as radiographs of the pelvic girdle. Conservative
treatment with a pelvic brace is the gold standard in pre- and postpartum cases of
symphysis dysfunction.
Keywords
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Article info
Publication history
Published online: March 11, 2015
Accepted:
February 28,
2015
Received in revised form:
January 26,
2015
Received:
October 18,
2014
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
