Symphysitis after childbirth

Symphysitis after childbirth is a fairly common problem in obstetrics, since childbirth is a complex process in which multiple processes take part, including those that have a direct impact on the pubic symphysis.

The medical term "symphysitis" means the presence of an inflammatory process in the joint between the pubic bones of the pelvis. Disturbances in this joint can be expressed in increased mobility of the bones, their divergence due to the influence of various factors.

Symphysitis can be provoked by pronounced secretion of the hormone relaxin, concomitant pathology of bones and joints, as well as other important factors.

The process of childbirth is a physiological condition, but it always passes without complications. After childbirth, pain syndrome may appear in the perineum and pubic area, discomfort when walking, climbing stairs and even in a sitting position.

A characteristic symptom is a "duck" gait due to pain in the area of the pubic pelvic bone junction. Similar symptoms may occur during pregnancy, when the pubic symphysis is exposed to the ever-increasing mass of the fetus and amniotic fluid. As a result, pain appears, most often beginning in the second half of pregnancy.

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Causes postpartum symphysitis

In the postpartum period, there is a possibility of developing some complications, one of which is symphysitis. This pathology occurs due to the formation of a large distance between the pubic bones due to their divergence.

The causes of symphysitis after childbirth are numerous. Thus, the development of symphysitis can be influenced by a large fetus as it passes through the birth canal, damaging it.

It is also worth considering that physiological processes in the body of a pregnant woman cause swelling and softening of the ligaments that hold the pubic bones at a certain distance from each other. As a result, the ligaments partially lose this ability, and the bones diverge.

The causes of symphysitis after childbirth should also be sought in the joints, which swell, thereby increasing their mobility. Normally, an increase in the distance between the pubic bones by 5-6 mm is allowed, but after childbirth, the joint should acquire its previous structure.

Symphysitis occurs against the background of an existing concomitant pathology, for example, with diseases of the joints and bone structures, traumatic damage to the sacrum, severe toxicosis, insufficient vitamin levels, or hormonal imbalance in women.

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Symptoms postpartum symphysitis

Clinical manifestations of symphysitis may appear during pregnancy or after childbirth. Initial symptoms of symphysitis after childbirth are periodic aching pains localized in the area of the pubic junction.

As the process progresses and there is no treatment, the pain syndrome becomes more pronounced and becomes a constant companion of any movements, and also bothers in a sitting position.

Such pain causes the appearance of a “duck” gait, which helps a woman to spare the pubic symphysis, reducing the intensity of the pain syndrome.

The pain is located not only in the pubic area, but also spreads to the perineum, lower back, hips and lower limbs. The most intense pain syndrome is noted when walking, bending forward, climbing stairs or turning in bed.

Symptoms of symphysitis after childbirth also include the appearance of a cracking sound when palpating the junction of the pubic bones of the pelvis. Its appearance is due to the increase in the distance between the bones and their increased mobility.

Similar clinical manifestations may appear immediately after birth or within 1-2 days.

Diagnostics postpartum symphysitis

Detection of symphysitis is based on clinical manifestations of the pathology, as well as the use of additional instrumental research methods.

Diagnosis of symphysitis after childbirth involves the use of ultrasound, X-ray, computed tomography and magnetic resonance imaging.

During pregnancy, only ultrasound is allowed to be used to avoid negative effects on the fetus. As for the postpartum period, all methods are allowed to be used to confirm the divergence of the frontal bones and exclude other pathologies.

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Differential diagnosis

Differential diagnostics of symphysitis after childbirth is carried out with infectious diseases of the urinary tract, pelvic bones, hernias (femoral or inguinal), lumbago, nerve compression due to pathology of the intervertebral disc, as well as thrombosis of the femoral vein.

In addition, using instrumental methods, the degree of symphysitis is determined. Thus, the first is characterized by a divergence of the pelvic bones within up to 9 ml, the second degree is up to 20 ml, and the third is over 20 ml. Evaluation of the degree of divergence of the pubic bones is necessary to determine further treatment tactics.

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Treatment postpartum symphysitis

Modern methods of therapeutic treatment of symphysitis can prevent surgical intervention and normalize anatomical structures. Drug treatment of symphysitis after childbirth involves the use of drugs that contain magnesium, calcium, and B vitamins.

In some cases, it is necessary to use antibacterial drugs, regardless of the degree of divergence. In addition, it is possible to use physiotherapeutic methods, such as ultraviolet irradiation, which will speed up the recovery process.

Treatment of symphysitis after childbirth includes some recommendations. They concern the limitation of any kind of physical activity, mandatory wearing of a bandage and the use of a mattress (orthopedic) for rest. In case of severe pain syndrome, painkillers should be used.

As for physical activity, it is recommended to perform certain exercises under the supervision of a specialist to strengthen the pelvic, gluteal and lumbar muscles.

Exercises for symphysitis after childbirth

Physical activity in symphysitis should be strictly controlled, avoiding intense loads, but, on the contrary, giving preference to special exercises. They must be performed regularly under the supervision of a specialist.

Exercises for symphysitis after childbirth help to strengthen and tone the muscles of the pelvis, perineum, lower back and buttocks. By doing them several times a day, you can notice that the pain syndrome gradually becomes less pronounced.

Now here are a few exercises that will gradually reduce the distance between the pubic bones of the pelvis. In a supine position, position your feet so that your heels are as close to your buttocks as possible. Now slowly move your knees apart and slowly return them back. You can repeat this up to 10 times, but start with 5.

Almost in the same position, only placing the feet further from the buttocks so that the shin becomes perpendicular to the floor. Now you need to try to raise the pelvis until it becomes level with the torso and thigh. It is recommended to repeat up to 10 times, also starting with a smaller number.

Kneeling down and relaxing your back, leaning on your palms, you need to slowly arch your back. At the same time, your neck and head should go down, and your abdominal muscles should tense up. You need to hold this position for up to 10 seconds. Then try, on the contrary, to arch your back, raising your head and again for 10 seconds. Repeat 3 times.

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Prevention

In order to prevent the pelvic bones from separating in the pubic symphysis area, it is necessary to follow some recommendations. They should be followed not only during pregnancy, but before and after it.

Prevention of symphysitis after childbirth consists of following a certain diet, the products of which are enriched with microelements, vitamins and minerals necessary for the delivery of phosphorus, zinc, calcium, magnesium, vitamin B and many other components in order to strengthen bone structures.

Pregnancy should not limit a woman's physical activity; on the contrary, by choosing the right set of exercises, you can not only prevent the development of symphysitis, but also facilitate labor. In addition, prevention of symphysitis after childbirth in the form of exercises is especially important, as they strengthen the pelvic, perineal, gluteal and lumbar muscles.

An important condition is long walks in the fresh air, since exposure to ultraviolet rays activates the synthesis of vitamin D.

Also, do not forget about monitoring concomitant pathology, which can affect calcium metabolism and hormone levels.

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Forecast

A slight divergence of the pubic pelvic bones does not have a negative impact on the fetus or the pregnant woman. After childbirth, their independent restoration of the physiological structure is also possible. In this case, the prognosis for symphysitis after childbirth is favorable.

However, with a significant increase in the distance between the pubic bones and intense clinical manifestations of symphysitis, some complications are possible. The prognosis of symphysitis after childbirth depends on the symptoms and instrumental examination data.

In addition, the prognosis will depend on the chosen treatment tactics. Significant divergence of the pubic junction requires the use of a bandage, cold, physiotherapy procedures and bed rest.

The main goal of such treatment is to achieve maximum convergence of the pelvic bones and maintain them in a physiological position.

Symphysitis after childbirth is very common, but varies in severity. Thus, if you follow the recommendations for preventing symphysitis, and if necessary, treatment measures, you can feel significant relief in a month.

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