Comparison between conservative and surgical management in postpartum pubic symphysis diastasis: a randomized controlled trial

Abstract

<p class="abstract"><strong>Background:</strong> Pubic symphysis diastasis is a postpartum complication with an incidence of 1:385 to 1:500 births. Typically conservative treatment is performed, operative treatment is also successful alternative method. This study was conducted to assess whether surgery (ORIF) provide early pain relief and improve mobility and quality of life than conservative management does in same patients<span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> This study is a randomized controlled trial conducted at MKCG Medical College, Berhampur from December 2014 to April 2017. Total eligible 16 postpartum pubic diastasis patients coming to MKCG hospital were randomly assigned to two groups in 1:1 ratio. Group A received surgical and group B conservative management. All were followed up at 3 weeks, 6 weeks, 3 months and upto 6 months in which EQ-5D-3L score and Visual analogue scale were measured for assessing pain and general health outcome in participants. All data were analyzed with SPSS.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean EQ-5D descriptive index was almost similar in both groups at the time of admission, but declined more rapidly in group A as compared to that in group B. 75% of group A has this index 5 (lowest score) at 6 months whereas none of the group B patients attained it. lower EQ-5D index indicates patients had good mobility and early ambulation, less discomfort, able to do usual activity. There was a significant difference in mean EQ-5D descriptive index and pain VAS score between two groups<span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> This study showed surgical management is more effective than conservative management in postpartum pubic symphysis patients by rapidly improving general health, ameliorating pain and bringing ambulation<span lang="EN-IN">.</span></p>

Postpartum pubic symphysis diastasis resulting in a prepubic abscess and osteomyelitis

“…Conservative treatment for PSD without an infection has shown to be successful in most cases. A reduction of symptoms was seen within 6 weeks in this group 24 25. Surgical treatment for PSD is rarely necessary, except for cases complicated by bleeding, nerve compression and urogenital tract trauma.…”

Management of symphysial dysfunction in pregnancy and post-partum period: A review

“…Surgical management is reserved for severe symphysial separation more than 4cm, symphysial separation persistent beyond 6 months. Surgical management is significantly more effective than conservative methods in those patients 38 .…”

Pubic Symphysis Diastasis in Pregnancy and Delivery (Review)

“…наиболее распространенным способом оперативной фиксации симфиза является внутренний остеосинтез с использованием пластин и винтов. Большинство авторов предпочитают доступ по пфанненштилю [20,24,63]. Я.Г.…”

“…после родов. по данным авторов, средняя оценка по ВаШ [63]. Ряд авторов предпочитают наружную фиксацию [38,52,65].…”