Rupture of the symphysis pubis during vaginal delivery followed by two subsequent uneventful pregnancies

Culligan, Patrick J.; Hill, Stephanie; Heit, Michael

doi:10.1016/s0029-7844(02)02155-5

Cited by 38 publications

(47 citation statements)

References 7 publications

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“…The present systematic review found use of physiotherapy as the main component of conservative treatment for the majority of women with SPD [1,4,7,10,12,[18][19][20][21]24,[27][28]. Most of the studies employed physiotherapy for walking reeducation, mobilization under supervision, and/or strengthening the core muscles, although only two studies detailed the stabilizing and/or strengthening exercises [10,15].…”

Section: Discussionmentioning

confidence: 99%

“…Most of the studies employed physiotherapy for walking reeducation, mobilization under supervision, and/or strengthening the core muscles, although only two studies detailed the stabilizing and/or strengthening exercises [10,15]. However, the start of the physiotherapeutic treatment varied from the 2nd to the 14th day after labor [1,[24][25]. Furthermore, no two women received exactly the same conservative treatment because the conservative methods differed among the studies.…”

Section: Discussionmentioning

confidence: 99%

“…The lack of detailed information from many studies precludes any recommendation for the best physiotherapy program to manage SPD [1,4,7,[19][20][21]. However, the studies that included exercise intervention reported good results in terms of pain and functionality after 2 wk when the exercise program consisted of strengthening and stability exercises [10].…”

Section: Discussionmentioning

confidence: 99%

“…The authors reported that the interpubic distance decreased, but significant pain and walking difficulty remained after 6 mo, and she needed full-time home healthcare for 3 mo. Additionally, although she returned to her normal activities 1 yr later, she had a residual 1.3 cm interpubic gap after 2 yr [1]. Snow and Neubert performed a retrospective case series study of 9 women with SPD (route of delivery: vaginal, number of infants delivered not specified) who received physiotherapy and TENS, in addition to bed rest, pain control with nonsteroidal anti-inflammatory drugs, and a pelvic girdle, but the authors did not describe any specific results [7].…”

Section: Physiotherapymentioning

confidence: 97%

“…During labor, factors contributing to dilation of the birth canal might result in the total or partial breakage of the pubic symphysis, defined as a diastasis of 10 mm or more and associated symptomatology [1][2][3][4]. This pathology is called symphysis pubis diastasis (SPD), and epidemiological studies estimate a 2.8 percent incidence of SPD in women during and post labor [5].…”

Section: Introductionmentioning

confidence: 99%

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Diastasis of symphysis pubis and labor: Systematic review

et al. 2015

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Abstract-Symphysis pubis diastasis (SPD) is an infrequent complication of labor that can impair womens' general health through failure of the passive stability of the pelvic girdle. Although conservative approaches are often used to decrease symptoms and interpubic separation, notably few studies have analyzed the effect of these methods on managing the symptoms of women with SPD. The purpose of this study was to review the available literature on the conservative treatment of SPD during pregnancy and labor. A computer-based search using PubMed, PEDro, and CINAHL was performed up to November 2014. We selected all studies that considered women with SPD during pregnancy or labor and treated them with conservative methods and excluded those that included surgical intervention. Eighteen studies were selected, most of which were case reports. Although the overall results of conservative treatment were unclear because of the type and design of the obtained studies, most of the studies reported bed rest in the lateral decubitus position and a pelvic girdle as basic treatments. Additionally, the few clinical trials reported recommended additional physiotherapy, including strengthening and stabilizing exercises, to reduce SPD symptoms.

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