A severe case of pubic symphysis diastasis in pregnancy

Seth, Sunita; Das, Banashree; Salhan, Sudha

doi:10.1016/s0301-2115(02)00221-x

Cited by 15 publications

(22 citation statements)

References 6 publications

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“…Thus, 13 articles [3,9,10,11,15,16,17,18,19,20,21,22,23] met the inclusion criteria and were analyzed in detail (table 1). Three articles were case series [3,18,21], the rest were reports of single cases [9,10,11,15,16,17,19,20,22,23].…”

Section: Resultsmentioning

confidence: 99%

“…Three articles were case series [3,18,21], the rest were reports of single cases [9,10,11,15,16,17,19,20,22,23]. …”

Section: Resultsmentioning

confidence: 99%

“…APC I injuries are associated with symphyseal widening <2.5 cm and intact anterior SI ligaments, APC II injuries with symphyseal widening >2.5 cm and intact posterior SI ligaments and APC III injuries with a SI disruption. Even though APC I-like injuries were reported in 7 patients [3,18] and APC III-like injuries in 3 patients [10,20,22], childbirth mainly led to pelvic instabilities comparable to APC II injuries [3,9,11,15,16,17,19,21]. …”

Section: Resultsmentioning

confidence: 99%

“…Postpartal symphyseal widening is comparable to traumatic pelvic ring injuries. Accordingly, like in traumatic symphyseal rupture, vaginal wall tears and even severe hemorrhage are possible in the acute situation [9,10,11]. Usually, patients are treated by the application of pelvic binders and bedrest up to several weeks.…”

Section: Introductionmentioning

confidence: 99%

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Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Osterhoff

Ossendorf

Ossendorf-Kimmich

et al. 2011

Gynecol Obstet Invest

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During pregnancy, asymptomatic widening of the symphysis pubis by about one third is normal and considered physiological. However, peripartal relaxation of the symphyseal and sacroiliac ligaments may cause significant complaints conditions including pain and gait dysfunction. Usually, patients are treated by the application of pelvic binders and bed rest up to several weeks. Surgical stabilization is performed seldom, though it may be promising in selected patients. Based on 2 cases of postpartum symphyseal instability treated by surgical fixation, the current literature was reviewed systematically to evaluate the outcome and potential complications of surgical fixation of symphyseal instability. Thirteen articles met inclusion criteria and were analyzed in detail. Including the two cases presented, surgical stabilization of postpartum symphyseal instability has been described for 33 patients. In conclusion, though only based on case reports and case series, early surgical stabilization represents a decent treatment option for postpartum symphyseal instability and may be indicated by pain or walking disability alone. In regard to the clinical outcome comparing internal and external fixation, no differences were demonstrable. However, the rate of infection was higher in patients treated by external fixation. Based on these data, we propose a treatment algorithm for this injury.

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Section: Resultsmentioning

confidence: 99%

“…Three articles were case series [3,18,21], the rest were reports of single cases [9,10,11,15,16,17,19,20,22,23]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Osterhoff

Ossendorf

Ossendorf-Kimmich

et al. 2011

Gynecol Obstet Invest

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“…A diastasis wider than 14 mm indicates concomitant damage of the sacroiliac joint with anterior lacerations on one or both sides of the ventral sacro-iliac ligament. A diastasis of the pubic symphysis after birth is a rare 5 but painful complication that causes serious distress to the patient. When this occurs, adequate treatment should be given while keeping in mind the needs of the mother and the baby.…”

Section: Introductionmentioning

confidence: 99%

Post partum diastasis of the pubic symphysis: a case report

et al. 2013

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The post partum diastasis ( means separation) of pubic symphysis is an uncommon disease. It causes acute pelvic pain. Manual pressure to the pelvis in a latero-lateral and antero-posterior direction worsens the condition. The diagnostic test for this condition is an anteroposterior X-ray of the pelvis. Here we present a case following spontaneous vaginal delivery. The conservative treatment is able to obtain good results. If this disease is underestimated the patient can develop chronic pain.CBMJ 2013 Jan:

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Pubic symphyseal face eburnation: an Egyptian sport story?

Judd

2009

Intl J of Osteoarchaeology

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Strenuous physical activity leaves scars on bone that attest to the demands of occupation, sport, aggression and recreation. During the assessment of 74 C-Group Nubians from Hierakonpolis (Egypt) dated to the Egyptian Middle Kingdom-Second Intermediate Period (2080-1700 BC), robust muscle insertions along the ilia and ischia were observed among some adults. In addition, a disproportionate degeneration of the pubic symphyseal faces when compared to other age-related features was also noted. In the case of one male (Burial 32), the pubic symphyseal faces were completely flattened and polished so that they resembled the eburnation that is pathognomic of osteoarthritis. Differential diagnoses are discussed and osteitis pubis, an increasingly diagnosed injury among modern athletes who participate in intense activity that involves running, kicking, twisting or leaping, is proposed as the most likely etiology. The exaggerated muscle insertions and pubic symphyseal wear, epitomised by the individual interred in Burial 32, are unique features that may be linked to the unexplained presence of this Nubian group deep in Egyptian territory during a period of political instability. Artefactual, artistic and documentary evidence records how the Egyptian pharaohs and elites conscripted Nubian athletes to the royal courts for staged contests and entertainment, part of a propaganda program engineered to reinforce among the general populace the dogma of Egyptian supremacy over the enemy. This Nubian community, serviced by Cemetery HK27C, may have functioned as a source for individuals skilled in athletics or other activities that required exceptional physical dexterity. The extraordinary modification of these pubic symphyseal faces underscores the importance of recognising paleopathological conditions that may further confound current macroscopic methods used to ascertain the chronological age of an individual.

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A severe case of pubic symphysis diastasis in pregnancy

Cited by 15 publications

References 6 publications

Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Surgical Stabilization of Postpartum Symphyseal Instability: Two Cases and a Review of the Literature

Post partum diastasis of the pubic symphysis: a case report

Pubic symphyseal face eburnation: an Egyptian sport story?

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