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Osteomyelitis of the Pubic Symphysis in Pregnancy

Gamble, Kendra MD1; Dardarian, Thomas S. DO1; Finstein, Joseph MD2; Fox, Edward MD2; Sehdev, Harish MD1; Randall, Thomas C. MD1

doi: 10.1097/01.AOG.0000199146.42113.0b
Case Report

BACKGROUND: Pubic symphysis osteomyelitis during the antepartum period of pregnancy is rare.

CASE: We report a patient in the third trimester who presented with pubic pain, low-grade fever, and altered gait. She was found to have a retropubic abscess at the time of cesarean delivery. Radiologic imaging showed findings consistent with osteomyelitis of the pubic symphysis and multiple pus collections in the pelvis and labia. The patient was treated with surgical debridement of the affected bone and placement of antibiotic-impregnated beads.

CONCLUSION: Osteomyelitis of the pubic symphysis can have serious complications. The diagnosis should be considered in pregnant patients with clinical findings unusual for pubic symphysis diastases. It can be treated with antibiotic-impregnated beads.

The diagnosis of osteomyelitis of the pubic symphysis in pregnancy is rare, but should be considered in patients with symphyseal pain.

From the 1Pennsylvania Hospital Department of Obstetrics and Gynecology; and 2University of Pennsylvania Department of Orthopaedic Surgery, Philadelphia, Pennsylvania.

See related case report on page 475.

Dr. Finstein is funded by Stryker-Howmedica-Osteonics.

Corresponding author: Kendra Gamble, MD, 4000 Presidential Boulevard #1304, Philadelphia, PA 19131; e-mail:

© 2006 The American College of Obstetricians and Gynecologists