Skip to main content
Log in

Clinical Presentation and Management of Peripartum Pubic Diastasis

  • Original Article
  • Published:
The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background

Symphysis pubis diastasis (SPD) is an uncommon peripartum complication which can have short-term morbidities secondary to pain and restricted movements as well as long-term complications. It is important to diagnose this condition as it causes significant discomfort to the nursing mothers. We present our experience in five patients with SPD who were managed successfully.

Methods

Present study is an observation of five cases of SPD managed in a single unit in a tertiary care center over three years from January 2017 to December 2019. All women with symptoms of SPD with inter-pubic distance of more than 10 mm were selected for the study. The demographic profile, clinical details, diagnostic imaging findings, and treatment provided for such patients were noted down from the individual case records. Follow-up of each patient for improvement in the symptoms and X-ray findings was available till 3 months for each case.

Results

Mean age of the women with SPD was 29.8 ± 5.4 years. Four women had vaginal delivery and one had vacuum delivery. Average birth weight is 3.26 ± 0.85 kg. Mean duration of first stage of labor is 6.6 ± 0.89 h and median of second stage is 35 min. Average inter-pubic distance at the time of diagnosis on X-ray was 1.84 ± 0.2 cm. All women were managed conservatively with bed rest, analgesics, pelvic binder and physiotherapy. Improvement in the range of movement was noted over average of 21.8 ± 3.7 days and symptoms resolved over 14.4 ± 2.6 weeks.

Conclusion

Treating obstetrician should be aware of this condition as simple treatment measures can avoid the long-term morbidities and complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Jain S, Edarapalli P, Janjute P, Sawdy R. Review pubic symphysis dysfumction: a practical approach to management. The Obstetr Gynecol. 2006;8:153–8.

    Google Scholar 

  2. Pregnancy related pelvic girdle pain- patient information leaflet. NHS, Royal Berkshire Nov 2020. 1–4

  3. Leadbetter RE, Mawer D, Lindow SW. Symphysis pubis dysfunction: a review of literatuire. Jf Mater Fetal Neonatal Med. 2004;16:349–54.

    Article  CAS  Google Scholar 

  4. Yoo JJ, Ha YC, Lee YK, Hong JS, Kang BJ, Koo KH. Incidence and risk factors of symptomatic peripartum diastasis of pubic symphysis. J Korean Med Sci. 2014;29:281–6.

    Article  Google Scholar 

  5. Sung JH, Kang M, Lim SJ, et al. A case–control study of clinical characteristics and risk factors of symptomatic postpartum pubic symphysis diastasis. Sci Rep. 2021;11:3289.

    Article  CAS  Google Scholar 

  6. Stolarczyk A, Stepinski P, Sasinowski L, Czarnocki T, Debinski M, Maciag B. Perpartum pubic symphysis diastasis- practical guidelines. J Clin Med. 2021;10:2443.

    Article  Google Scholar 

  7. Coldron Y. Margie Poldon Memorial lecture: ‘Mind the gap!’Symphysis pubis dysfunction revisited. J Assoc Chart Physiother in Women’s Health. 2005;96:3–15.

    Google Scholar 

  8. Gupta P, Malik R. Case series of pubic bone diastasis causing severe pelvic girdle pain in pregnancy. Int J Reprod Contracept Obstet Gynecol. 2019;8(11):4612–6.

    Article  Google Scholar 

  9. Young G, Jewell D. Intervention for preventing and treating pelvic and back pain in pregnancy. Cochrane Database Syst Rev. 2002;1:CD001139.

    Google Scholar 

  10. Herren C, Sobottke R, Dadgar A, Ringe MJ, Graf M, Keller K, et al. Peripartum pubic symphysis separation—Current strategies in diagnosis and therapy and presentation of two cases. Injury. 2015;46:1074–80.

    Article  CAS  Google Scholar 

  11. Ayeni GO, Oladire O, Jovita DA, Ethelbert OO, Chukwuemeka OC. Transcutaneous electrical nerve stimulation (TENS) in the management of peripartum diastasis symphysis pubis (DSP): cases report. Indian J Physiother Occup Ther. 2015;9(3):221–5.

    Article  Google Scholar 

  12. Urraca-Gesto MA, Plaza-Manzano G, Ferragut-Garcias A, Pecos-Martin D, Gallego-Izquierdo T, Romeo-Franco N. Diastasis of symphysis pubis and labour: systematic review. J Rehabil Res Dev. 2015;56(6):629–40.

    Article  Google Scholar 

Download references

Funding

No funding availed for this article.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Avantika Gupta.

Ethics declarations

Conflict of interest

The author declares no conflict of interest.

Consent for Publication

We hereby transfer, assign, or otherwise convey all copyright ownership, including any and all rights incidental thereto, exclusively to the journal, in the event that such work is published by the journal.

Ethical Approval

Ethical approval not required for case series as per the Institutional Ethics Committee guidelines.

Informed Consent

Informed consent obtained from the patients and their identity not disclosed.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Dr. Avantika Gupta is associate professor at department of Obstetrics & Gynaecology, Jawaharlal Nehru Institute of Postgraduate Medical Education & Research (JIPMER), Puducherry, India. Dr. Jayalakshmi Durairaj is professor at department of obstetrics and gynecology, JIPMER, Puducherry. Dr. Avanthi Gadipudi is senior resident at department of obstetrics and gynecology, JIPMER, Puducherry. Dr. Veena Pampapati is professor at department of obstetrics gynecology, JIPMER, Puducherry. Dr. Deepthi Nayak is Senior resident at department of obstetrics and gynecology, JIPMER, Puducherry.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gupta, A., Durairaj, J., Gadipudi, A. et al. Clinical Presentation and Management of Peripartum Pubic Diastasis. J Obstet Gynecol India 72 (Suppl 1), 146–151 (2022). https://doi.org/10.1007/s13224-021-01590-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13224-021-01590-y

Keywords

Navigation