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Labor and Delivery Considerations: Pubic Symphysis Separation, Fractures Associated with Transient Osteoporosis of Pregnancy, Sacral Stress Fractures, and Coccydynia/Coccyx Fracture

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Musculoskeletal Health in Pregnancy and Postpartum

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Abstract

Labor and delivery is a time when women are susceptible to musculoskeletal injuries. Pubic symphysis separation can occur during labor and delivery and result in pain and difficulty ambulating. Conservative treatment is generally recommended with physical therapy and nonsteroidal anti-inflammatory medications for pain control. Transient osteoporosis of pregnancy typically occurs in the third trimester and is important to recognize during pregnancy. There have been multiple reports of fractures reported during labor and delivery, including hip fractures, vertebral fractures, and sacral fractures. Cesarean section is generally recommended in patients with transient osteoporosis of pregnancy. Coccydynia can also occur from injuries during labor and delivery. Initial treatment of patients with coccydynia is conservative, including pain management, a donut pillow, and physical therapy. If conservative management fails, injections should be considered. Correct diagnosis of the above injuries can lead to decreased pain and early functional improvement for the women suffering from the injuries.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, University of Missouri, One Hospital Drive, DC 046.00, Columbia, MO, 65212, USA

    Sarah K. Hwang MD

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  1. Sarah K. Hwang MD
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Correspondence to Sarah K. Hwang MD .

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Editors and Affiliations

  1. Department of Obstetrics & Gynecology, Loyola University, Maywood, Illinois, USA

    Colleen M. Fitzgerald

  2. Department of Rehabilitation Medicine, University of Kansas, Kansas City, Kansas, USA

    Neil A. Segal

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Hwang, S.K. (2015). Labor and Delivery Considerations: Pubic Symphysis Separation, Fractures Associated with Transient Osteoporosis of Pregnancy, Sacral Stress Fractures, and Coccydynia/Coccyx Fracture. In: Fitzgerald, C., Segal, N. (eds) Musculoskeletal Health in Pregnancy and Postpartum. Springer, Cham. https://doi.org/10.1007/978-3-319-14319-4_10

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  • DOI: https://doi.org/10.1007/978-3-319-14319-4_10

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-14318-7

  • Online ISBN: 978-3-319-14319-4

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