Peripartum pubic symphysis separation: a case series and review of the literature.
Peripartum pubic symphysis separation: a case series and review of the literature.
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DOI：
10.1097/00006254-199707000-00023
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发表时间：
1997-07-01
影响因子：
6.2
通讯作者：
Neubert, A G
中科院分区：
文献类型：
--
作者：
Snow, R E;Neubert, A G
围产期耻骨联合分离是公认的妊娠并发症，发病率估计为1：300至1：30，000。耻骨联合分离的特征性症状包括耻骨上疼痛和压痛，放射到腿后部，行走困难，偶尔膀胱功能障碍。临床病史、症状和治疗反应足以做出诊断，尽管X线或超声检查联合分离的影像学记录经常用于确诊。症状性联合分离的潜在病因尚未完全阐明。多产、巨大儿、病理性关节松动和骨盆环受力增加被认为是可能的病因。保守治疗，包括卧床休息，骨盆捆绑器，amphetamine设备，和温和的止痛药通常导致4至6周的完全恢复。联合分离的发生不应显著改变后续妊娠的处理，对于任何症状复发，建议保守治疗。回顾性分析了1994年至1995年5121例分娩的经验，发现9例围产期联合分离，导致569例分娩中有1例发生。详细介绍了这一系列的情况和文献综述。
Peripartum pubic symphysis separation is a recognized complication of pregnancy with incidence estimates ranging from 1:300 to 1:30,000. Characteristic symptoms of symphyseal separation include suprapubic pain and tenderness with radiation to the back of legs, difficulty ambulating, and occasionally, bladder dysfunction. Clinical history, presenting symptoms, and response to therapy are sufficient to make the diagnosis, although radiographic documentation of symphyseal separation by x-ray or ultrasound are frequently used to confirm the diagnosis. The underlying etiology of symptomatic symphyseal separation has not been fully elucidated. Associations with multiparity, macrosomia, pathological joint loosening, and increased force placed on the pelvic ring have been suggested as possible etiologies. Conservative therapy, including bedrest, pelvic binders, ambulation devices, and mild analgesics usually result in a complete recovery with 4 to 6 weeks. The occurrence of a symphyseal separation should not significantly alter the management of subsequent pregnancies, and conservative therapy is recommended for any recurrence of symptoms. A retrospective review of our experience with 5121 deliveries from 1994 to 1995 found 9 cases of peripartum symphyseal separation, resulting in an incidence of 1 of 569 deliveries. Details regarding this case series and a review of the literature are presented.