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Severe separation of the pubic symphysis and prompt orthopedic surgical intervention

Gena C Dunivan1, Ashley M Hickman, AnnaMarie Connolly

  • 1From the Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

Obstetrics and Gynecology
|July 23, 2009
PubMed

Insights

Severe pubic symphysis separation, a rare delivery complication, can cause significant pain and mobility issues. Aggressive treatment with external fixation and physical therapy enabled early recovery and self-care.

Area of Science:

  • Obstetrics and Gynecology
  • Orthopedic Surgery
  • Pelvic Health

Background:

  • Pubic symphysis separation occurs in 1 in 300 to 30,000 pregnancies.
  • Complications include pain, bladder dysfunction, and ambulation difficulties.
  • Optimal treatment for pregnancy-related pubic symphyseal separation lacks consensus.

Observation:

  • A gravida 1 para 1 patient experienced severe pubic symphysis separation (6.2 cm) and vaginal sidewall laceration post-vacuum-assisted delivery.
  • The patient presented with an open book pelvis.
  • Treatment involved external fixation and physical therapy.

Findings:

  • The patient achieved spontaneous voiding by postpartum day 4.
  • Early ambulation with a walker was possible.
  • External fixation facilitated a rapid recovery.

Implications:

  • Aggressive management of severe pubic symphysis separation is effective.
  • External fixation can lead to early functional recovery.
  • This approach improves patient outcomes and ability to care for self and newborn.
Abstract

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