Symphysitis after childbirth
Last reviewed: 23.04.2024
All iLive content is medically reviewed or fact checked to ensure as much factual accuracy as possible.
We have strict sourcing guidelines and only link to reputable media sites, academic research institutions and, whenever possible, medically peer reviewed studies. Note that the numbers in parentheses ([1], [2], etc.) are clickable links to these studies.
If you feel that any of our content is inaccurate, out-of-date, or otherwise questionable, please select it and press Ctrl + Enter.
Symphysitis after childbirth is a fairly common obstetric problem, because labor is a complex process in which multiple processes take part, including those that have a direct effect on the lone articulation.
The medical term "symphysitis" means the presence of an inflammatory process in the joint between the pubic pelvic bones. Violations in this compound can be expressed in an increase in the mobility of bones, their divergence due to various factors.
Symphysitis can be triggered by the expressed secretion of the hormone relaxin, concomitant pathology of bones and joints, as well as other important factors.
The process of birth refers to the physiological state, but it always passes without complications. After birth, there may be a pain syndrome in the crotch and pubic area, discomfort when walking, climbing the stairs and even in the sitting position.
A characteristic symptom is the "duck" gait due to pain in the area of the connection of the pubic hips of the pelvis. Similar symptoms can occur even during pregnancy, when the longevity is affected by the ever-increasing mass of the fetus and the amniotic fluid. As a result, there is the appearance of pain, beginning most often from the second half of pregnancy.
[1],
Causes of the symphysitis after childbirth
In the postpartum period, there is the possibility of developing some complications, one of which is symphysitis. This pathology arises from the formation of a large distance between pubic bones due to their discrepancy.
The causes of symphysitis after childbirth are numerous. So, the development of symphysitis can be influenced by a large fetus as it passes through the birth canal, damaging them.
In addition, it is worth considering that the physiological processes in the body of the pregnant cause puffiness and softening of the ligaments, which keep the pubic bone 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 joints that swell, thereby increasing their mobility. Normally, an increase in the distance between the pubic bones by 5-6 mm is permissible, but after the birth the joint must acquire the old structure.
Symphysitis occurs against the background of already existing concomitant pathology, for example, in diseases of joints and bone structures, traumatic damage to the sacrum, severe toxicosis, insufficient levels of vitamins or violation of the hormonal status of women.
Symptoms of the symphysitis after childbirth
Clinical manifestations of symphysitis may appear during pregnancy or after childbirth. The initial symptoms of symphysitis after childbirth are periodic nagging pain localized in the region of the lonnage.
As the process progresses and the lack of treatment, the pain syndrome acquires a more pronounced color and becomes a constant companion of any movements, and also disturbs in a sitting position.
Such pain causes the emergence of a "duck" gait, which helps a woman spare spinal articulation, reducing the intensity of the pain syndrome.
The pains are located not only in the pubic region, but also spread to the perineal region, the lower back, the hips and lower extremities. The most intense pain syndrome is noted when walking, bending forward, climbing a staircase or turning in bed.
Symptoms of symphysitis after childbirth also consist in the appearance of cod when the palmar bones of the pelvis are probed. Its appearance is due to an increase in the distance between the bones and their increased mobility.
Such clinical manifestations can appear immediately after birth or within 1-2 days.
Diagnostics of the symphysitis after childbirth
Identification of symphysitis is based on clinical manifestations of pathology, as well as using additional instrumental methods of investigation.
Diagnosis of symphysitis after childbirth involves the use of ultrasound, X-ray, computer and magnetic resonance imaging.
When pregnancy is allowed to use only ultrasound to avoid adverse effects on the fetus. With regard to the postpartum period, it is allowed to use all methods to confirm the divergence of the frontal bones and the exclusion of another pathology.
[6]
Differential diagnosis
Differential diagnosis of symphysitis after childbirth is carried out with infectious diseases of the urinary tract, pelvic bones, hernia (femoral or inguinal), lumbago, compression of the nerve due to the pathology of the intervertebral disc, and thrombosis of the femoral vein.
In addition, using instrumental methods, establishes the degree of symphysite. So, the first one is characterized by the divergence of the pelvic bones in the range up to 9 ml, at the second degree - up to 20 ml and the third - over 20 ml. Estimation of the degree of divergence of pubic bones is necessary for determining further therapeutic tactics.
Who to contact?
Treatment of the symphysitis after childbirth
Modern methods of therapeutic influence on symphysitis can prevent surgical intervention and normalize anatomical structures. Medical treatment of symphysitis after childbirth provides for the use of medicines that contain magnesium, calcium, and also vitamins of group B.
In some cases it is necessary to use antibacterial drugs, regardless of the degree of discrepancy. In addition, it is possible to use physiotherapeutic methods, for example, ultraviolet irradiation, which will accelerate the recovery process.
Treatment of symphysitis after childbirth includes some recommendations. They concern the restriction of any kind of physical activity, the obligatory wearing of a bandage and the use of a mattress (orthopedic) for rest. In severe pain syndrome, anesthetics should be used.
As for exercise, it is recommended that certain exercises be performed under the supervision of a specialist to strengthen the pelvic, gluteal and lumbar muscles.
Exercises in symphysitis after childbirth
Physical activity in symphysitis should be strictly controlled, avoiding intensive loads, but, on the contrary, giving preference to special exercises. They must be regularly performed under the supervision of a specialist.
Exercises with symphysitis after childbirth help to strengthen and improve the tone of the muscles of the pelvis, perineum, waist and buttocks. Performing them several times a day, you can see that the pain syndrome is gradually becoming less pronounced.
Now, actually a few exercises, with which the distance between the pubic pelvic bones will gradually decrease. In the supine position on the back, the feet should be positioned so that the heels are as close as possible to the buttocks. Now you need to slowly bend your knees to the sides and just slowly return it back. You can repeat it up to 10 times, but start with 5.
Practically in the same position, only by placing the feet farther from the buttocks, so that the shin becomes perpendicular to the floor. Now you need to try to lift the pelvis until it becomes level with the trunk and thigh. Repeat is recommended up to 10 times, also starting with fewer.
Having knelt and relaxed his back, leaning on the palm of your hand, you need to slowly bend your back. Thus the neck and the head should fall, and muscles of a stomach or belly - to strain. So it is necessary to stay up to 10 seconds. Then try, on the contrary, to bend your back, lifting your head and again for 10 seconds. Repeat 3 times.
Prevention
In order to prevent the discrepancy of the pelvic bones in the area of the lone articulation, it is necessary to adhere to certain recommendations. They should be performed not only during pregnancy, but before and after it.
Prevention of symphysitis after childbirth consists in observing 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 the bone structures.
Pregnancy should not restrict the physical activity of a woman, on the contrary, by choosing the right set of exercises, one can not only prevent the development of symphysitis, but also facilitate labor activity. In addition, the prevention of symphysitis after labor 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, because under the influence of ultraviolet rays, the synthesis of vitamin D is activated.
Also, do not forget about the control of the concomitant pathology, which can affect the calcium metabolism and the level of hormones.
Forecast
Slight discrepancy of the pubic pelvic bones does not adversely affect the fetus or the pregnant. After delivery, their independent restoration of the physiological structure is also possible. In this case, the symphysitis prognosis is favorable after delivery.
However, with a pronounced increase in the distance between pubic bones and intensive clinical manifestations of symphysitis, some complications are possible. The prognosis of symphysitis after childbirth depends on the symptoms and the data of instrumental research.
In addition, the forecast will depend on the chosen therapeutic tactics. A significant discrepancy in the lone joint causes the use of a bandage, cold, physiotherapy and bed rest.
The main goal of such treatment is to achieve maximum convergence of the pelvic bones and their retention in the physiological position.
Symphysitis after delivery is very common, but differs in degree of severity. So, if you follow the recommendations for the prevention of symphysitis, and if necessary - medical measures, you can feel a significant relief in a month.