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Symphyseal Separation

Jain, Neeta MD; Sternberg, Lawrence B. MD

doi: 10.1097/01.AOG.0000149744.82912.ea
Case Reports
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BACKGROUND: Separation of the pubic symphysis up to 1 cm during pregnancy and delivery occurs frequently. This report presents a woman who experienced a large symphyseal separation.

CASE: Following delivery, a 35-year-old primipara complained of hip and groin pain associated with leg movement. An anterior-posterior pelvic X-ray showed a pubic separation of 9.5 cm and a 3–5 mm widening of the sacroiliac joints. She was treated with a pelvic binder, walker, and physical therapy. The diastasis has since undergone progressive reduction.

CONCLUSION: Separation of the pubic symphysis during pregnancy and delivery is normal. However, a large separation is a potential complication requiring treatment and follow-up. Conservative management including analgesia, rest, and a pelvic binder is a reasonable method of management.

Significant symphyseal separation is a rare obstetrical complication with varied etiologies and should be considered in postpartum patients complaining of suprapubic pain and ambulatory difficulties.

University of Rochester School of Medicine and Dentistry, Rochester, New York

Received April 7, 2004. Received in revised form May 9, 2004. Accepted May 12, 2004.

Address reprint requests to: Neeta Jain, MD, c/o Lawrence B. Sternberg, MD, 256 Alexander Street, Rochester, NY 14607; e-mail: Neeta.Jain@stanfordalumni.org.

© 2005 The American College of Obstetricians and Gynecologists