The divergence of the pubic articulation is 7 mm. The pubic joint during pregnancy. Treatment of divergence and rupture of the pubic symphysis

During pregnancy, without exception, all the organs of the female body change. This also applies to the musculoskeletal system, since the bones of the pelvis diverge so that the baby can be born into the world.

Anatomy of the female pelvis

The bones of the pelvis, coccyx and sacrum form a pelvis, which outwardly resembles a closed ring. The pelvic bones include the ischial, pubic and iliac. Peculiarity female pelvis in that it not only supports all internal organs, but also conducts the child during childbirth, so all the cartilage and ligaments of this part of the body can become softer. This also applies to the pubic joint, which, under the influence of relaxin, becomes softer and more mobile. Thanks to this property, the pelvis can adjust to the girth of the baby's head.

Concept and symphysite

Symphysitis during pregnancy is inflammatory process in the pubic joint. However, this pathology is not common. When a woman is waiting for the birth of her baby, it is more appropriate to apply medical term symphysiopathy, which means too high level cartilage softness and strong stretching bones (more than 0.5 cm). It is worth noting that in non-pregnant women, the distance between the bones is no more than 0.2 cm, although in the period from 18 to 20 years this distance may increase slightly (up to 0.6 cm), and then gradually narrow.

Sometimes in the process labor activity there is a rupture of the symphysis during the divergence of the pelvic bones and inflammation begins. This pathology is called symphysitis.

Signs of pathology

Symptoms of symphysitis are quite easy to recognize, especially if the divergence of the pubic joint is accompanied by inflammation:

The patient complains of pain in the pubis (drawing or shooting);
may occur;
At physical activity the pain intensifies, especially if the woman tries to move the thigh to the side;
However, when the patient is at rest, the pain subsides or disappears completely;
In some cases pain may spread to the back, abdomen, and thighs;
A pregnant woman's gait changes (waddle, or "duck");
On palpation of the pubic joint, severe pain is felt;
May occur.

Considering the listed symptoms of symphysitis during pregnancy, it is also necessary to indicate that about half of the women in this delicate position feel a slight pain in the pubis. This is considered normal, because as the baby grows and the body prepares for childbirth, the symphysis softens and the ligaments stretch. Especially bright discomfort occurs in the last weeks of pregnancy. Therefore, a woman just needs to be patient, after giving birth, the discomfort will pass.

But if the pain is very strong, or even unbearable, and the inability to move and sleep normally joins it, there is every reason to assume the presence of symphysitis.

Causes and degrees of the disease

It is worth noting that symphysitis does not occur in all pregnant women. This pathology can be caused by a number of factors:

Physiology connective tissue(dysplasia)

Sometimes patients are diagnosed with natural weakness of the ligaments and connective tissue. However, this phenomenon is not as common as it seems. For example, children with this pathology are more likely to suffer from dislocations and sprains, they may have problems with the heart or kidneys. Pregnant women with dysplasia may experience increased discomfort in the ligaments.

genetic predisposition

Most doctors are of the opinion that the risk of symphysitis and rupture of the pubic symphysis is much higher in women whose closest relatives had the same pathology.

kidney disease

AT medical practice there is an opinion that any pathology of the kidneys (in particular, pyelonephritis) provokes accelerated elimination minerals and protein in the urine. This process causes too much softening and divergence of the pelvic bones.

Lack of calcium and vitamin D

Quite often, although not always, it is calcium deficiency that leads to excessive softening of the symphysis. Associated features there may be fractures and increased fragility of hair and nails.

In addition, symphysitis can occur after numerous births and pelvic injuries. The degrees of pathology are determined by the distance over which the pelvic bones have diverged:

The first is 0.5-0.9 cm;
The second - 1-2 cm;
The third is more than two centimeters.

Pregnant women are often interested in the question of how to determine the degree of symphysitis. AT this moment most exact method diagnosis is ultrasound, but on palpation, the doctor will also be able to notice the unstable position of the pelvic bones and excessive softness of the cartilage tissue.

The impact of pathology on pregnancy and childbirth

Symphysiopathy does not affect the course of pregnancy, it only worsens general well-being women. However, too much stretching of the cartilage already during childbirth can lead to cartilage rupture. This is a rather serious injury, as a result of which a woman loses her ability to work for several months.

A high risk of severe discrepancy and further rupture of the pubic symphysis after childbirth occurs in women with a narrow pelvis with a large child (more than 4 kg). That is why quite often patients with similar physiological features recommend delivery by caesarean section to minimize trauma to the mother.

Manifestations and danger of rupture of the symphysis

Regardless of the time of occurrence of symphysiolysis (before childbirth, after them, or in the very process of labor), the symptoms of the pathology remain the same: a woman cannot raise her legs, get out of bed on her own (you can only get up in a position on her side), unable to climb stairs, and especially severe cases cannot even move his legs, as any movement causes severe pain.

And although the pathology does not pose a threat to life, childbirth with symphysis is a very dangerous process due to high risk gap, which is very serious injury. If the discrepancy is no more than two centimeters, the fracture is not considered dangerous. But if the bones have separated by 5 cm or more, there is an immediate danger to the woman's health.

First of all, the edges of the bones can damage the clitoris, bladder or urethra. In addition, hemorrhages in the joints may occur, which later lead to arthritis. Fortunately, these injuries are rare and can be treated with surgery.

Diagnostic methods

If a pregnant woman complains of pain in the pubis, it becomes difficult for her to walk, and the pubis becomes slightly swollen, doctors in without fail a number of diagnostic procedures are prescribed:

ultrasound

This procedure allows you to accurately determine the distance between the bones of the pelvis and determine the signs of the inflammatory process. However, diagnosis is complicated by the fact that women with minimal bone dehiscence feel severe pain, while patients with long distance between pelvic bones practically do not feel discomfort.

As a result of the ultrasound, the patient will receive data on the degree of divergence of the bones, and further diagnosis will be based on the analysis of complaints.

x-ray

Most often this remedy used after childbirth to determine the rupture of the symphysis and the effectiveness of treatment. During pregnancy, x-rays are rarely taken, and only special indications when there is a need to accurately estimate the size of the pelvis and head of the baby.

MRI and CT

These are the most accurate diagnostic methods, which are also used after childbirth. With the help of these procedures, it is possible not only to evaluate the effectiveness of treatment, but also to identify other pathologies in the pelvis.

The main difficulties in diagnosing

Very often, pain similar to symphysitis can be caused by completely different pathologies. Therefore, pregnant women are advised to immediately report them to the gynecologist at the first sensations of discomfort for further examinations.

Pain in the pubis, in addition to symphysitis, can cause the following diseases:

Lumbago is characterized by severe and acute back pain caused by a pathology of the spine (for example, a hernia or osteochondrosis). The pain very often radiates to the leg, abdomen, or groin, and can lead to urinary and bowel problems.
sciatica or pain in sciatic nerve. The pain syndrome can cover a very large area of the body: from the groin or coccyx along the entire leg to the lower leg. In addition, such pain can be a sign of arthritis, arthrosis, muscle damage, or tumors in the pelvis.
Bone diseases, including tuberculosis and osteomyelitis. These pathologies are not very common, but they should also be taken into account in the diagnosis. The risk group includes women who have previously suffered a pelvic injury or have been sick with tuberculosis.
infections genitourinary system often cause pain in the pubis. coli, genital infections or, in addition to burning in the groin, also cause acute tingling pain. And since pregnant women are much more likely to get cystitis, it is imperative to be screened for infections.

To exclude or confirm the presence of these diseases, the patient must undergo an ultrasound scan, pass a urine culture for infections, as well as a smear of the vaginal microflora.

Treatment Methods

Softening of the pubic joint is a characteristic companion of childbirth. However, after the birth of the baby (after about 6 months), all manifestations of the pathology disappear on their own. In some cases, discomfort persists for up to a year, but still this does not require medication. However, if there was a rupture of the symphysis during childbirth, treatment will be required and will depend on the degree of pathology.

Treatment of symphysitis during pregnancy is reduced to the removal unpleasant symptoms:

A woman does not need to walk, sit or climb stairs for too long;
Being in a stationary position, you need to evenly distribute the load on the limbs;
With symphysitis, it is recommended to wear a prenatal bandage (already from the 25th week). This will help relieve pain and relieve pressure on the symphysis;
A woman needs to include calcium-rich foods in her diet, but in some cases, preparations with this substance are prescribed by the attending physician. However, take similar drugs need only in the dosage indicated by the doctor, since an excess of calcium (especially on later dates pregnancy) can also harm the fetus. It is also not recommended to take calcium supplements in the last weeks before childbirth.
A pregnant woman needs to control her weight, because too much body weight increases the load on the bones and ligaments of the pelvis.

For the correct treatment of pathology, it is necessary to consult not only a gynecologist, but also an orthopedist. In some cases, it is recommended to additionally visit a physiotherapist and a neurologist.

There are also exercises that can help relieve pain:

Kegel exercises help strengthen muscles pelvic floor. Performing exercises is reduced to movements that mimic the retention of a stream of urine. Doing them regularly will help take the load off the pelvic bones and make them more stable.
Cat pose (kneeling position with a straight back and straightened shoulders). After you have taken the starting position, you need to start arching your back, lowering your head down and stretching your abdominal muscles. The exercise is repeated several times.
Raising the pelvis is performed as follows: the woman lies on her back, bends her knees, and begins to slowly lift the pelvis up, fixing it as high as possible.

It is important to consider that any exercises are performed only in the absence of contraindications and if they do not provoke increased pain.

After childbirth, the treatment of symphysitis includes the following procedures:

Taking painkillers

Often, NSAIDs are used to eliminate pain: Ibuprofen, Paracetamol. However, such drugs can only be used to relieve very severe pain, since the constant use of medications can cause ulcers or liver dysfunction. In addition, if a woman is breastfeeding, she should definitely consult a doctor so as not to harm the baby.

Bed rest

If a severe degree of pubic symphysis divergence or its rupture was diagnosed, the patient is shown a strict bed rest. Sometimes they use a special hammock in which weights are suspended (crosswise). This allows you to fuse the pelvic bones faster.

Reducing physical activity

If the discrepancy was minimal, it is enough for the patient to limit motor activity and use a cane to get around.

Pelvic girdle

To enhance the effect of using a hammock, a woman is recommended to wear a special pelvic belt. It consists of belts to which weights are attached. The belt is tightened looser or tighter in various parts body to speed up the healing of tears.

Bandage

To prevent further separation of the pelvic bones and reduce pain, the patient is advised to wear a special bandage, which also speeds up the healing process.

Physiotherapy

In some cases, magnetotherapy is used for treatment, but this method effective only in combination with bed rest and bone fixation.

Surgical intervention

If the rupture was not treated in a timely manner, and the patient continues to feel pain, an operation is performed. To restore the pelvis, they insert into it plastic materials or rods.

Prevention

Since doctors have not yet been able to determine exact reason the occurrence of symphysitis, it is also impossible to prevent this condition. But if a pregnant woman follows a number of recommendations, she will significantly reduce the risk of rupture of the symphysis:

) with the delivery of all necessary tests;
Consult with your doctor about the method of childbirth. In some cases, natural childbirth is contraindicated, and only a caesarean section can prevent injury;
During pregnancy and while breastfeeding, a woman should eat well;
If pain or limited movement is felt, a woman should immediately consult a doctor;
If necessary, a pregnant woman is prescribed an additional course of calcium or iodine;
If there are injuries or fractures during previous births, this information must be reported to the doctor;
In late pregnancy, an ultrasound scan is mandatory to determine the estimated size of the baby;
In the presence of diabetes, it is necessary to constantly monitor the level of sugar in the blood, as this can potentially lead to the birth of an oversized baby.

Carrying a child is fraught with enormous difficulties to endure. female body. Most of the obvious changes do not have to be explained, but sometimes some changes in the body of the expectant mother cause concern. One of these exciting factors, needing special attention, - pubic articulation. Where is located, what are the reasons for the possible appearance of pain in his area and how to deal with it, every pregnant woman should know.

Pubic symphysis

The pubic joint, which also has a second name - the pubic symphysis, consists of two pubic bones hip joint, connected by fibrocartilaginous tissue along the midline. It is located in front bladder above the external genital organs and is attached to elastic ligaments.

The body of a woman in the prenatal period is subject to cardinal changes that affect her hormonal balance. The result of exposure to hormones such as progesterone and relaxin is the softening of all ligaments. The pubic joint, where it is located cartilage tissue, also becomes less static. Often this leads to unnatural painful mobility of the pubic symphysis.

During pregnancy, the purpose of exposure to these hormones is to increase the flexibility of the joints and bone structure, which contributes to the facilitated course of labor. Meanwhile, dysfunction of the pubic symphysis is rare in patients and requires immediate action.

Divergence of the pubic joint

The appearance of space between the pubic bones is called a discrepancy. Such a diagnosis is subject to ascertaining on the basis of the complaints described by the pregnant woman. Symptoms often include:

- pain in the pubic region, which can respond with unpleasant aching sensations below, "pull" the leg and groin;

— sudden pain during load movements (turning from side to side, climbing stairs, etc.);

- a kind of cracking of the joints is possible when the hip moves;

- painful pressure

To obtain more accurate diagnostic data, an ultrasound of the pubic symphysis and MRI should be performed.

The latter will help determine the degree and width of the discrepancy, which can reach one of three levels:

1 - width is 5-9 mm;
2 - width is 10-20 mm;
3 - width over 20 mm.

Reasons for the divergence of the pubic symphysis

The pubic joint during pregnancy is threatened due to impaired metabolism and lack of vitamin D. For example, hormones produced parathyroid gland, are involved in the regulation of phosphorus-calcium metabolism in the body. In case of a lack of calcium intake, required for the full development and growth of the fetus, the body begins to draw necessary substance from the mother's stock. The main source of calcium for the unborn baby will be mother's teeth and bones. Also, diseases of the gastrointestinal tract and diabetes may be the cause of calcium deficiency. In turn, vitamin D significantly affects the absorption of incoming calcium by the body.

The divergence of the pubic joint begins to develop long before the birth of the child. However, the effect of hormones and the weight of the fetus contribute to the manifestation of the above symptoms only in II or III trimester. Often, the signs of pathology that have appeared are not given due attention and are attributed to osteochondrosis, sciatica, and the threat of abortion.

Timely diagnosis is extremely important. It will help you take time necessary measures treatment, prevent Negative consequences by natural delivery or by caesarean section.

Discrepancy treatment

Usually, when the pubic bones diverge, no intervention is required. After successful delivery flexibility, elasticity and integrity of the pubic symphysis are subject to restoration in a natural way.

Wearing a bandage;

Performing gymnastic exercises;

Appointment of the necessary medical preparations(magnesium, calcium, vitamins, especially group B).

A woman in labor should inform obstetricians about the presence of this pathology before the onset of labor.

The discrepancy, which turned into more severe degree, is fraught with rupture of the pubic joint. In order to avoid further expansion of the pubic bones, doctors also strongly recommend limiting, preferring bed rest.

Rupture of the pubic symphysis

If the divergence of the pubic bones is observed mainly during gestation, then a rupture is possible during the birth process.

Among the varieties of breaks, violent and spontaneous ones are distinguished. The latter occur during spontaneous labor activity. The reason for the appearance of violent ruptures is often called the use of additional efforts when extracting the fetus, manual separation placenta In addition, the introduction of a hand into the uterine cavity in most cases is a decisive factor in the probable rupture of the pubic joint.

Treatment of ruptures of the pubic symphysis

If a rupture occurs, the patient needs strict bandaging. The area of the hip joint is subject to tight bandaging. It is optimal for this purpose to use a linen wide bandage. On the back of the bed, you should install the legs and attach blocks to them at the level of the pelvis. The ends of the bandage must be tied on wooden planks, which are tied with cords. These cords pass through the blocks, and a load must be hung at their ends, starting from a couple of kilograms and gradually increasing to 10 kg.

Due to the early recognition of the rupture, the restoration of the pubic joint occurs in 2-3 weeks. In case of delayed treatment, the bandage is applied for at least 1 month. Often for this purpose, bandages are used from a cloth resembling a hammock. Its edges are attached to the longitudinal slabs. The pelvic bones begin to converge due to the gravity of the patient's weight. The recovery time for staying in a hammock is the same.

The musculoskeletal functions of the pelvis are fully restored with the treatment approach carried out without delay. With a more backward definition of a rupture, the inflammatory process of cartilaginous tissues contributes to difficult fusion and protracted rehabilitation.

Damage to the symphysis during childbirth is one of the defense mechanisms from the side female body provided by nature. Someone has a narrowed pelvis, someone has inelastic ligaments, someone just inherited some structural features. To prevent rupture of the symphysis, you need to engage in prenatal preparation. There are schools for expectant mothers where they teach stretching exercises. Just shaping or general gymnastics is not enough. Need special exercises for stretching the muscles and ligaments of the pelvis, for example, the lotus position.

The opinions of doctors about the variant of childbirth after the divergence of the pubic joint diverge. Some say that symphysitis is an indication for caesarean section in subsequent pregnancies. Others that this diagnosis in itself is not yet an indication for surgery. The indication is the divergence of the pubic joint for a distance greater than a centimeter. If the fetus is large, the pelvic opening is narrow, or the baby's head is too strong, then the symphysis may be damaged during childbirth.

Symphysiopathy is determined long before birth. By at least, two weeks before the due date, the doctor will know for sure whether your symphysis is in order or not. Crisping indicates “malfunctions”, slight pain, a feeling of discomfort, as if the bones were “out of place”. The critical divergence distance is ten millimeters.

If the birth began, and a week before there was no evidence due to symphysiopathy, then no one will do an emergency caesarean. Unless, of course, there is some other need.

If you are still very afraid of giving birth on your own, I think you can contact paid clinic, or talk to your doctors again, insisting on a caesarean section.
Symphysiopathy can occur in the second and third trimesters of pregnancy. Symptoms - pain in the pubic joint when walking.

Significant discrepancy can be identified in several ways:

1. To the touch: whether the fingertip is placed in the resulting discrepancy.
2. According to the changed gait: if used to be a woman walked, as usual, now she moves in a waddle, "duck".

3. Using X-ray of the pubic symphysis. There is one big "but" here. Since symphysiopathy is a phenomenon that manifests itself in the later stages, the baby in many cases already turns its head down by this time, and in this position X-rays get him, which is undesirable. If these signs are found, then, most likely, a caesarean section will be shown.

If the symphysis is nevertheless damaged, the first and most important rule is: do not panic. Need to see a doctor X-ray. If the discrepancy was “missed” in the maternity hospital, and the woman found it already at home, then you need to go to the maternity hospital to your obstetrician - unfortunately, this issue is not resolved at the site in the clinic. And it is necessary to use a special corset, which helps to keep the pelvic bones in a certain state. Its size is from the waist line to the lower gluteal crease. The structure allows the woman to regulate it herself and pull it down exactly as much as she needs. Feels like she herself will understand exactly where this line is. This corset is quite soft and flexible due to elastic inserts, it is easy to move in it. You need to wear it constantly, without taking it off - from three to six months, because the pubic symphysis recovers slowly.

Of course, a young mother should limit the load: relatives should free the woman as much as possible from any housework. And we are talking not about caring for a child - this mother can do herself. The main thing for her is not to do any other difficult work: wash floors, lift weights.

AT folk medicine such damage was treated simply: women tightly tied themselves with a sheet. But this method was ineffective - home-made corsets weakened, slipped, and sometimes there was no time to tie them at all. The women approached traditional healers. Remember: only strong long-term fixation of the joints can help. Otherwise, the treatment will take much longer and more difficult, and no one can guarantee that the treatment will give results.

Additionally

During the period of bearing a child, a woman may face various difficulties. Approximately half of all expectant mothers are concerned about the pubic symphysis. Unpleasant sensations may appear both at the very beginning of the period, and closer to childbirth. This article will tell you about what is the divergence of the pubic symphysis during pregnancy. You will learn the features of the course of pathology and how to diagnose it.

What it is

The pubic symphysis is the so-called area that connects the lateral bones. It is worth noting that this area is also in the body of a man. The pubic symphysis is attached to the bones by ligaments. Their stretching usually does not exceed five millimeters.

The described area is located above the penis in men and on top of the clitoris in women. Outwardly, it resembles a trapezoid, turned upside down with a smaller base. Symphysis, or pubic joint, has a structure cartilaginous disc. It can move freely under the influence of some factors.

Divergence of the pubic symphysis

Most often, in the normal state, this part of the body does not bother men and women. However, during the gestation of the fetus, everything can change. So, about fifty percent of the fairer sex, who are in an interesting position, are faced with the fact that there is a strong sprain. In this case, we are talking about the divergence of the pubic symphysis.

With a slight deviation from the norm, no correction is required. However, a strong increase in the gap between the pubic joint and the pelvic bones leads to unpleasant symptoms. In especially severe cases, a woman is forced to seek help from doctors.

Diagnosis of pathology

To determine the condition of a pregnant woman and the complexity of the situation, it is necessary to perform an ultrasound of the pubic symphysis. You can also examine the aforementioned area using x-rays. However, during the period of bearing a baby, they try not to use this method. There are several stages of pathology.

First degree of divergence. In this case, the symptoms are not pronounced. The gap between the pelvic bones and the pubic joint is no more than nine millimeters. Often, expectant mothers have this particular form of articulation divergence.
Second stage. At this stage, the length of the ligaments is stretched to two centimeters. At the same time, the woman already feels quite unpleasant symptoms. Doctors advise it is with the second degree of discrepancy to seek help.
Third degree. When the bones move away from the pelvic bases by more than two centimeters, we are talking about the third stage of the pathology. It is worth noting that the symptoms in this case become very pronounced. Sometimes a woman simply cannot move normally.

In addition to information obtained through ultrasound diagnostics or X-ray, the doctor must take into account the patient's complaints. Sometimes it also happens that the symptoms are very pronounced, while the discrepancy does not exceed one centimeter.

Symptoms of the divergence of the pubic joint

Rupture of the pubic symphysis is always accompanied by unbearable pain. With the development of such a complication, a person simply cannot move independently. However, among the symptoms of the onset of pathology (discrepancies), the following sensations can be distinguished:

severe shootings in the pubic region, radiating to the groin and lower part peritoneum (sometimes the lower back and upper thighs are involved in the process);
inability to perform simple movements (climbing stairs, walking, getting out of bed, and so on);
sound sensation of a click when moving (increased during raising the leg up);
premature prolapse of the abdomen;
pain on palpation of the pubic area and during sexual intercourse.

As noted above, during pregnancy, a woman may notice premature prolapse of the abdomen. This is due to the fact that the bones diverge, and the baby begins to gradually move into the pelvic cavity.

Why is this happening

What causes the pubic symphysis to diverge during pregnancy? Doctors talk about several reasons for the development of this condition. All of them can be divided into conditions that developed directly due to pregnancy, as well as pathologies that the future mother had earlier.

The main reason for the discrepancy is hormonal changes. Immediately after fertilization and implantation of the cell into the uterine cavity, active production of progesterone begins. This hormone is essential for normal development embryo. It has a relaxing effect on the uterus, preventing it from contracting. A similar effect is achieved in other organs and ligaments. Since the pubic symphysis is attached to the ligaments, they can stretch.

Another reason for the development of pathology can be a lack of vitamins. Calcium becomes the main deficient substance. A large amount of this component is necessary for the formation of the fetus. However, if future mom eats incorrectly or does not take vitamin complexes, the fetus begins to take calcium from her body. Bones, teeth, nails and hair are primarily affected.

Vitamin D deficiency can also play a big role. If a woman in an interesting position receives the right rate calcium, but at the same time there is not enough vitamin D in her body, then the substance is simply not absorbed. The consequence of this is bad condition teeth, fragility of nails and bones, including the pubic symphysis.

Corrective measures

How to treat pubic symphysis during pregnancy? In most cases, a woman is not assigned any medical preparations. However, with strong painful sensations need to take painkillers medicinal formulations. These include Paracetamol. It is the safest during this period. Also in the second trimester, Nurofen or ibuprofen-based products can be used. However, such drugs can be used only on the recommendation of a specialist and after the diagnosis.

With pathology of the first degree, the expectant mother is advised to be careful in movement. When getting up from a bed or a chair, do not make sudden actions. When climbing stairs, first place one foot on the step, then transfer the other to the same place. Try to use elevators and less

In especially difficult situations (in the second or third stage of the pathology), a woman may be prescribed bed rest. This state is recommended to be maintained until the very birth. At the same time, drugs that relieve inflammation and relieve pain can be shown.

Using a bandage and corset

In the second half of pregnancy and before childbirth, doctors recommend wearing a bandage or a special corset. Such manipulations will help relieve pain and support the body of the uterus. It is worth noting that it is necessary to use such funds only after consulting a specialist. Support devices should be sized and worn only in the prone position.

Doctors recommend wearing selected accessories for several days after childbirth. It is at these moments that the reverse development of pathology occurs. Supportive and slimming accessories will help improve the condition of the newly-made mother.

delivery

With the development of pathology, classical delivery is usually performed. At the same time, do not forget to inform the obstetricians about your condition. Physicians must take this into account in the process.

When it comes to the second or third stage of the discrepancy, a caesarean section may be chosen. If the ligaments are sprained and a distance of more than two centimeters is formed between the pelvic bones and the pubic articulation area, it is carried out. Otherwise, the ligaments may rupture, and emergency surgical intervention will be required.

Summing up the article

You now know what the pubic symphysis is. Photo of this site human body presented to your attention in the article. Often, expectant mothers attribute the symptoms that arise to malaise, fatigue, arthritis, threatened miscarriage, or neurological pathologies. However, the more you do nothing, the more difficult it will be to cope with the pathology in the future. Seek medical attention promptly. Carry out corrective and preventive actions. Health to you and good health!

Symphysitis during pregnancy is not an exceptional phenomenon. About half of expectant mothers face pathology. Anatomical science calls the symphysis the area in which the pubic bones are connected. During pregnancy, the rapidly gaining mass fetus exerts significant pressure on the bone joint, which makes it mobile. A slight divergence of the pubic bones is considered a physiological necessity and prerequisite for comfortable childbirth, and excessive softening of the joint is referred to as a disease of the musculoskeletal system and is called symphysitis.

At non-pregnant woman the pubic articulation is a strong, immovable joint. With the advent of the fetus in the mother's body, the tissue between the bones of the pubis softens greatly. excessive movable joint becomes under the influence of the hormone relaxin, which is secreted in the body of the expectant mother in in large numbers. What the pubic joint looks like, fettered by symphysitis during pregnancy, shows a photo:

Scientists cannot say that the reasons for such a metamorphosis have been thoroughly studied. It is still not clear why the pubic articulation in some pregnant women softens moderately and does not cause them significant inconvenience, while in others the pathology is so pronounced that it practically hinders all movements. Nevertheless, there are certain conjectures about the prerequisites for the development of the disease in physicians. The following factors contribute to the appearance of symphysitis:

Insufficient concentration of calcium in the bones.
A significant deficiency of vitamins in the body of a pregnant woman.
Excessive synthesis of the hormone relaxin under the influence of an "interesting" position.
Heredity.
Diseases of the musculoskeletal system that appeared in a woman before pregnancy.

Symptoms of symphysitis during pregnancy

Weak echoes of the disease make themselves felt already in the 4th month of the "interesting" situation. Complete clinical picture symphysitis unfolds in the 3rd trimester of pregnancy - painful symptoms reach their climax. Here are the most significant and common of them:

The pubic joint initially swells slightly, with time the inflammation and, accordingly, the swelling increase.
The pain of movement forces the expectant mother to walk, waddling from side to side like a duck. Sometimes a woman begins to mince - this allows you to minimize the mobility of the hip joint when walking.
If you feel the inflamed area, the woman will feel severe pain. On palpation, you can hear single clicks or a crunch.
The pain is also felt when changing the position of the body.
There is a feeling of heaviness in the lower abdomen.
because of severe pain the woman is unable to raise her straightened leg.
When climbing stairs, the intensity of unpleasant symptoms increases.
As pregnancy develops, symphysitis also progresses, bringing discomfort to the expectant mother even during passive rest.

What threatens symphysitis during pregnancy

We note right away that during pregnancy, pain during symphysis causes inconvenience only to a woman, without affecting the condition of her baby in any way. True, some doctors are sure that the depressed state of a woman tormented by pain can affect the child not the most. in the best way, but there is no reliable confirmation of this.

A woman suffering from symphysitis has the following problems:

at natural childbirth the risk of rupture of the symphysis increases - the loose tissue of the joint is so weakened that it may not withstand the pressure that the fetus will exert when passing through birth canal. rehabilitation period takes a lot of time (more than two weeks), while the woman is shown exclusively bed rest;
the method of delivery is changing - with a divergence of the pubic joint, it is safer to resort to a caesarean section than to give birth on your own;
after childbirth, symphysitis will remind the woman of herself for some time. And this greatly complicates new image the life of a young mother, when caring for a baby, the need to visit various specialists and perform a complex of therapeutic exercises, and so take a lot of effort.

Diagnosis of symphysitis during pregnancy

Diagnosis about pathological condition the obstetrician-gynecologist puts the pubic joint, taking into account the results of the examination and complaints of the pregnant patient. The signs of symphysitis during pregnancy are quite eloquent, so, as a rule, there are no problems with the definition of the disease.

After the introduction of the procedure into the practice of diagnostic medicine ultrasound specialists got an excellent opportunity not only to identify the disease, but also to get as much information about it as possible. With the help of ultrasound with symphysitis during pregnancy, you can determine the stage of development of the disease:

the complication of the first degree is expressed by the expansion of the gap of the pubic junction by 5–9 mm. If there are no other deviations, a woman can still hope for a natural birth;
the second degree of symphysitis is set if the crack between pubic bones increased by 10 - 20 mm. The doctor will have to decide on the method of delivery;
the third degree of pathology is indicated by a large distance between the bones of the pubic joint (more than 20 mm). The birth of a child is possible only through surgery.

Treatment of symphysitis during pregnancy

Symphysiopathy is one of those rare conditions that exists only for a certain period of time (in this case – recent months pregnancy), and then "resolves" without any medical intervention. The most difficult thing is to wait for this moment, because the divergence of the pubic articulation is accompanied by a rather strong pain syndrome. The delicate position of a woman imposes a taboo on the use of effective anti-inflammatory and analgesic drugs, since they active substances can harm intrauterine development child. The choice of available techniques for eliminating discomfort from symphysitis is not very large, however, it is better than nothing at all:

Pregnant women can take calcium supplements as prescribed by a doctor. However, despite the criticality of the position of the expectant mother with symphysis, this step is rather controversial. When there is very little time left before childbirth, the amount of this trace element in the diet of pregnant women is usually shown to be limited in order to prevent the development of complications during childbirth. Of course, calcium makes a woman's bones stronger, but at the same time bone tissue on the eve of childbirth, it is impossible to purposefully compact, since its elasticity is important for normal delivery. In addition, increased calcium intake thickens the baby's skull, and this can make it difficult for him to move through the tight and strong birth canal.
Suspend the stretching process and reduce the severity clinical signs symphysitis will help special therapeutic exercises. A set of exercises is aimed at strengthening the pelvic, lumbar and thigh muscles. Exercises are best performed under the supervision of an instructor in a specialized medical institution. Exercise stress, not related to therapeutic exercises, should be limited to a minimum.
An excellent support for muscles weakened by symphysitis is a bandage. Expectant mother must wear it.

Exercises for symphysitis during pregnancy

To make the course of pregnancy with symphysis less painful, you need to do gymnastics every day - this is the only way to strengthen the pelvic, sacral, lumbar and femoral muscles.

Gently lie back on the mat. Bend your knees and move your feet to your buttocks as close as you can. Now slowly and very smoothly begin to spread your knees to the sides. Hold this position for a few moments, and then just as smoothly connect your knees. Repeat 4-6 times.
Still lying on your back, place your feet in such a way that calf muscles were perpendicular to the floor. Now gently lift your pelvis up. Remember your position and do not be too zealous - it is enough to raise the buttocks by just a few centimeters. Slowly lower yourself back to the starting position. When you almost touch the surface of the floor with your tailbone, try to delay this moment for a few moments and only then lower yourself to the floor. Perform 5 - 6 repetitions.
The complex is completed by the well-known exercise “cat”. Get on all fours and relax your back. The head, neck and spine should be in the same line. Very slowly round your back, and lower your head and tailbone down. Ideally, you should feel the tightening of the thigh and groin muscles. Now carefully return to the original position. Repeat the exercise 2-3 times.

Important! If possible therapeutic gymnastics should be performed several times a day, especially at times of severe pain.

How can a pregnant woman prevent the development of the disease

The divergence of the pubic articulation is not dangerous for a woman's life, however, in combination with certain factors (a narrow pelvis of a woman in labor and a large fetus, for example), it can have severe consequences. Also, the degree of symphysitis during pregnancy depends on how well the expectant mother will feel in the last months before childbirth.

It is obvious that a pregnant woman should pay maximum attention to the prevention of symphysiopathy, especially if she has all the prerequisites for its development. Main preventive measures consider the use of vitamins, regular swimming in the pool and moderate exercise. It is also very important to discuss with your doctor the features of the diet - every day the body of a pregnant woman should receive enough calcium.

If some signs of symphysitis have already made themselves felt, the pregnant woman must be prevented at all costs. further development illness. The following recommendations will help to stop the progression of symphysiopathy and ease the pain of symptoms:

Change your body position as often as possible. You can not sit in front of a TV or computer for a long time, hunched over and cross-legged - this position blocks blood circulation in the pelvic area and lower extremities.
Throughout the third trimester of pregnancy, you need to wear a special bandage that reduces the load on the pelvis and pubic joint.
Perform a daily set of exercises that strengthen the muscles of the hips, pelvis and lower back.
In moments of exacerbation of the disease, do not hesitate to use various devices that will ease the load on the affected area - walkers, canes, wheelchairs.
To lie down, first gently sit on the bed, then gently lean to the side to lay down. upper part torso, and then simultaneously lift both legs, pressed against each other, and lay them on the bed. To get out of bed, use the reverse sequence. When turning from one side to the other, always keep your legs together.
If possible, use the stairs as little as possible.
Too soft and too hard surfaces for sitting with symphysis are contraindicated.
When walking, move smoothly, taking not very wide steps.
To painlessly get into the car, first seat your ass in the passenger compartment, and carefully bring your legs brought together next.
Swimming in warm water quickly relieves pain in the area of the pubic joint.
According to many women who have experienced bouts of symphysitis during pregnancy, it is most convenient to sleep at night with a small pillow between your legs.
Beware of asymmetry in body position.
Never sit cross-legged - in your situation this is the strictest taboo.
When standing, do not shift the center of gravity to one foot, but evenly distribute the load on both legs.
Try not to lean on one elbow/arm.
Prolonged sitting, especially if the knees are above the level of the pelvis, is not for you.
Avoid lengthy hiking. As often as possible, alternate periods of mobility with short-term rest.
Take body weight under strict control: the less extra pounds- the easier it is to cope with the discomfort that the divergence of the pubic joint brings you.
All the time try to reduce the pressure of the child on the lower back, pelvis and pubis. The following tricks will help you achieve this:

resting, put your feet on a hill;
when lying down, place a rolled-up towel under your buttocks so that your pelvis is in a slightly elevated position.

These are not at all complicated rules will help you cope with the unpleasant manifestations of symphysitis in anticipation of the baby. If the pain is so severe that it completely knocks you out, be sure to tell your obstetrician-gynecologist about this.

The prognosis of symphysiopathy during pregnancy is favorable, provided that the expectant mother will responsibly follow all the recommendations of the attending physician. Note that it is impossible to cope with symphysitis on your own - only qualified specialist will be able to choose the right tactical approach to solving the problem.