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The Journal of Bone and Joint Surgery 78:1746-8 (1996)
© 1996 The Journal of Bone and Joint Surgery, Inc.

Disruption of the Symphysis Pubis during Vaginal Delivery. A Case Report*

DAVID L. KOWALK, M.D.{dagger}, PHILIP S. PERDUE, M.D.{dagger}, F. JOHN BOURGEOIS, M.D.{dagger} and RICHARD WHITEHILL, M.D.{dagger}, CHARLOTTESVILLE, VIRGINIA

Investigation performed at the University of Virginia Health Sciences Center, Charlottesville


   Introduction
 
Slight separation of the symphysis pubis during pregnancy is considered to be physiological and caused by hormonally induced ligamentous laxity. However, complete separation of the symphysis pubis during vaginal delivery is rare; the prevalence has been reported2,3,7,9 to range from one in 521 to one in 20,000. Separations of more than ten millimeters are usually associated with tenderness and difficulty with walking and are thought to be pathological3,5,7,9.

In the current report, we describe the case of a patient who had a wide separation of the symphysis pubis during vaginal childbirth. To the best of our knowledge, this is the second reported case of disruption of the symphysis pubis during spontaneous vaginal delivery1. Our purpose is to emphasize that this type of disruption differs from other traumatic symphyseal diastases with respect to both natural history and treatment.


   Case Report
 
A twenty-eight-year-old healthy woman (gravida two, para two) was transferred to . . . [Full Text of this Article]


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