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Updated: Jun 3, 2026

Vessel-sparing Excision and Primary Anastomosis
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Practical symphysiotomy: an overview.

Arun Paul Choudhury1, Banasree Bhadra, Arunava Roy

  • 1Department of Obstetrics and Gynaecology, Silchar Medical College, Silchar 788014.

Journal of the Indian Medical Association
|March 17, 2011
PubMed
Summary

Symphysiotomy, a surgical procedure dividing the symphysis pubis, offers a safe alternative for obstructed labor, increasing pelvic diameter to facilitate natural childbirth with minimal complications.

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Area of Science:

  • Obstetrics and Gynecology
  • Surgical Procedures
  • Maternal Health

Background:

  • Cephalopelvic disproportion can lead to obstructed labor, posing risks to mother and child.
  • Cesarean section is a common but resource-intensive intervention for obstructed labor.
  • Symphysiotomy presents a less invasive surgical option to increase pelvic dimensions.

Purpose of the Study:

  • To evaluate the efficacy and safety of a modified subcutaneous symphysiotomy technique.
  • To assess the outcomes of symphysiotomy in cases of established obstructed labor.
  • To compare symphysiotomy with cesarean section in terms of complications and resource utilization.

Main Methods:

  • A review of 21 cases of established obstructed labor treated with a modified subcutaneous symphysiotomy.
  • The procedure involved complete division of the upper symphyseal ligament and partial division of the anterior arcuate ligament under local anesthesia.
  • The posterior arcuate ligament was intentionally left intact.

Main Results:

  • All 21 cases successfully delivered vaginally without the need for forceps or vacuum extraction.
  • The modified subcutaneous symphysiotomy resulted in a permanent increase in pelvic diameter.
  • Complications were negligible compared to the morbidity and mortality associated with primary cesarean sections.

Conclusions:

  • Modified subcutaneous symphysiotomy is a safe and effective procedure for managing established obstructed labor.
  • This technique offers a viable alternative to cesarean section, particularly in resource-limited settings.
  • Training gynecologists in this justified and properly selected procedure could expand its use in rural hospitals.

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