Korean J Obstet Gynecol.  2011 Feb;54(2):107-110. 10.5468/KJOG.2011.54.2.107.

A 80 mm separation of the symphsis pubis during vaginal delivery

Affiliations
  • 1Department of Obstetrics and Gynecology, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea. raksumi10@gmail.com
  • 2Department of Orthopedics, National Health Insurance Corporation Ilsan Hospital, Goyang, Korea.

Abstract

Separation of the symphysis pubis during the vaginal delivery is rare, but a serious complication. Treatment is generally conservative with rest and appropriately fi tted pelvic binder. But surgery may be necessary when symphyseal separation is more than 40 mm. A case of 80 mm separation of symphysis pubis developed after vaginal delivery is presented with review of the literature.

Keyword

Symphysis pubis; Vaginal delivery; Separation

Figure

  • Fig. 1. A 80 mm separation of the symphysis pubis (5 days after vaginal delivery).

  • Fig. 2. After 12 days of delivery showing a 30 mm separation of the symphysis pubis with parts of pelvic brace.

  • Fig. 3. At readmission, after 35 days of delivery showing a 20 mm separation of the symphysis pubis with parts of pelvic brace.

  • Fig. 4. After 6 months of delivery showing without any instrument.


Reference

1. Wurdinger S, Humbsch K, Reichenbach JR, Peiker G, Seewald HJ, Kaiser WA. MRI of the pelvic ring joints postpartum: normal and pathological findings. J Magn Reson Imaging. 2002; 15:324–9.
Article
2. Snow RE, Neubert AG. Peripartum pubic symphysis separation: a case series and review of the literature. Obstet Gynecol Surv. 1997; 52:438–43.
3. Brehm W, Weirauk HV. Separation of the symphysis pubis during labor. Am J Obstet Gynecol. 1928; 15:187–91.
Article
4. Taylor RN, Sonson RD. Separation of the pubic symphysis. An underrecognized peripartum complication. J Reprod Med. 1986; 31:203–6.
5. Reis RA, Baer JL, Arens RA, Stewart E. Traumatic separation of the symphysis pubis during spontaneous labor. Surg Gynecol Obstet. 1932; 55:336–54.
6. Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Rouse DJ, Spong CY. Williams obstetrics. 23rd ed.New York: McGraw-Hill Medical;2010.
7. Bahlmann F, Merz E, Macchiella D, Weber G. Ultrasound imaging of the symphysis fissure for evaluating damage to the symphysis in pregnancy and postpartum. Z Geburtshilfe Perinatol. 1993; 197:27–30.
8. Heyman J, Lundqvist A. The symphysis pubis in pregnancy and parturition. Acta Obstet Gynecol Scand. 1932; 12:191–226.
9. Dhar S, Anderton JM. Rupture of the symphysis pubis during labor. Clin Orthop Relat Res. 1992; 283:252–7.
Article
10. Kharrazi FD, Rodgers WB, Kennedy JG, Lhowe DW. Parturition-induced pelvic dislocation: a report of four cases. J Orthop Trauma. 1997; 11:277–81.
Article
11. Cappiello GA, Oliver BC. Rupture of symphysis pubis caused by forceful and excessive abduction of the thighs with labor epidural anesthesia. J Fla Med Assoc. 1995; 82:261–3.
12. Heath T, Gherman RB. Symphyseal separation, sacroiliac joint dislocation and transient lateral femoral cutaneous neuropathy associated with McRoberts’ maneuver: a case report. J Reprod Med. 1999; 44:902–4.
13. Musumeci R, Villa E. Symphysis pubis separation during vaginal delivery with epidural anesthesia: case report. Reg Anesth. 1994; 19:289–91.
14. Hagen R. Pelvic girdle relaxation from an orthopaedic point of view. Acta Orthop Scand. 1974; 45:550–63.
Article
15. Culligan P, Hill S, Heit M. Rupture of the symphysis pubis during vaginal delivery followed by two subsequent uneventful pregnancies. Obstet Gynecol. 2002; 100:1114–7.
Article
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