Open Rupture of the Symphysis Pubis During Spontaneous Delivery

Blum, M; Orovano, N.

doi:10.3109/00016347609156789

Cited by 13 publications

(9 citation statements)

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“…However, conservative treatment implies bedrest for up to 6 weeks [12,13,14], although it is known that length of hospitalization and immobility are the main risk factors for pressure ulcers, thromboembolism and pneumonia [27,28]. Furthermore, nonoperative treatment of symphyseal instability is almost always associated with persistent pain and disability in walking for 6–16 weeks [3,12,13,14,29]. …”

Section: Discussionmentioning

confidence: 99%

“…Surgical stabilization is rarely suggested and if so only in patients with symphyseal widening of more than 2.5 cm [15,20,30] or in patients with failed conservative treatment [18,25,31] or concomitant soft tissue injuries [12,32]. Concomitant injuries of the genito-urinary tract are common and usually have to be reconstructed surgically [9,10,11,23].…”

Section: Discussionmentioning

confidence: 99%

“…Usually, patients are treated by the application of pelvic binders and bedrest up to several weeks. In addition to a vague prospect of success, potential complications and hazards of this conservative treatment include thromboembolism and musculoskeletal deconditioning [12,13,14]. In contrast, in selected patients, a more aggressive yet more targeted procedure may be promising.…”

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: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

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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“…However, pregnancy-related severe pubic diastasis must be reduced and fixed to allow pelvic ring reconstruction and early functional rehabilitation. [ 5 6 7 8 ] Delay to surgery and persistent instability may result in residual, chronic pelvic pain.…”

Section: Introductionmentioning

confidence: 99%

Intrapartum pubic symphysis disruption

Pires

Labronici

Giordano

et al. 2015

Ann Med Health Sci Res

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During pregnancy, high progesterone and relaxin levels produce physiological ligament relaxation on the pelvis. Therefore, moderate pubic symphysis and sacroiliac joints relaxing provide birth canal widening, thereby facilitating vaginal delivery. Sometimes, functional pain or pelvic instability may occur during pregnancy or puerperium, which is defined as symptomatic pelvic girdle relaxation. In rare cases, a pubic symphysis disruption can occur during the labor, causing severe pain and functional limitations. The early recognition of this injury is crucial to prevent complications and improve clinical and functional outcomes. This study reports an acute symphyseal disruption resulting from childbirth in a primiparous patient who underwent open reduction and internal fixation with plate and screws. After a 6 months follow-up, the patient presented no pain and satisfactory functional recovery.

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“…It is usually seen in elderly (older than 35) primagravida and there are few reports of this injury in younger patients [4,5]. Conservative treatment was reported to be successful in most cases, and operative management was considered in severe displaced case.…”

Section: Introductionmentioning

confidence: 99%

Severe postpartum disruption of the pelvic ring: report of two cases and review of the literature

et al. 2011

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Pelvic dislocations are rare during labor, and the treatment is controversial. We report two cases of young women who sustained postpartum disruption of the pelvic ring: one case is an 8.8 cm wide separation of the pubic symphysis with sacroiliac joint disruption underwent surgical stabilization and the second case with 4.0 cm disruption being treated non-operatively. These cases illustrated of importance of accurate diagnosis, careful physical exam, fully informed consent and specific treatment for this condition.

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Open Rupture of the Symphysis Pubis During Spontaneous Delivery

Abstract: Abstract. The clinical and roentgenological picture of symphysiolysis is very well known. In contrast, the rarer syndrome of the rupture of the symphysis pubis during spontaneous delivery is less well known.

Cited by 13 publications

References 0 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

Intrapartum pubic symphysis disruption

Severe postpartum disruption of the pelvic ring: report of two cases and review of the literature

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