Puerperal diastasis of the pubic symphysis. A case report

BACKGROUND: Puerperal diastasis of the symphysis pubis is an uncommon intrapartum complication. Patients often respond to conservative measures. A small percentage of patients will develop chronic pain and require surgical treatment, which involves debridement or fusion of the symphysis pubis. CASE: A 33-year-old woman, gravida 1, para 0, with an uncomplicated prenatal course developed acute-onset anterior pubic pain during an otherwise normal delivery. This anterior pubic pain radiated to the left buttock and thigh. The pain persisted postpartum and was exacerbated by any movement. Radiographs confirmed pubic symphysis diastasis. The patient responded to conservative management and was essentially pain free by 10 weeks postpartum. CONCLUSION: The diagnosis should be considered in a patient with an acute onset of pain during delivery that does not improve postpartum.