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Disjunction of the symphysis pubis after vaginal delivery: Case report
Fedoua Watik1, Mouna Harrad1, Soukaina Sabir1
1Obstetrics and Gynecology Department, University Hospital Ibn Rochd, Faculty of Medicine and Pharmacy, Hassan II University of Casablanca, Morocco.
Introduction:
Pubic joint enlargement of more than 10 mm is diagnosed and defined as diastasis of the pubic symphysis and is considered a complication of vaginal delivery or pregnancy. As it is a rare pathology.
Case Presentation:
We report a patient with severe pelvic pain with impotence of the left IM at day 1 of a dystocic delivery. The clinical examination revealed a sharp pain on palpation of the pubic symphysis. The diagnosis was confirmed by a frontal radiology of the pelvis showing a 30 mm enlargement of the pubic symphysis. The therapeutic management consisted in a preventive unloading and anti-coagulation with an analgesic treatment based on paracetamol and NSAID. The evolution was favorable.
Clinical Discussion:
The therapeutic management consisted of a discharge and preventive anti-coagulation with an analgesic treatment based on paracetamol and NSAID. The evolution was favorable.
Conclusion:
The initial early management is medical with the association of oral analgesia, local infiltration, rest and physiotherapy. Pelvic bandaging and surgical treatment are reserved for cases of important diastasis and must be associated with preventive anticoagulation in case of immobilization.
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