Separation of the pubic symphysis. An underrecognized peripartum complication

Abstract

A retrospective review of symphysial separations during pregnancy revealed an incidence of 1:600 deliveries over the previous five years. This figure reflects an occurrence 40-fold or more frequent than the current literature suggests. All the cases in our 11 patients suffering peripartum pubic rupture occurred after spontaneous vaginal deliveries. Maternal age, parity, clinical pelvimetry and fetal weight did not play a clear role in the development of symphysiolysis. Rapid descent of the presenting part in the second stage, however, was a common feature. Nonoperative treatment of pubic diastasis and expectant management of subsequent deliveries seem advisable.