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Case Reports in Obstetrics and Gynecology
Volume 2014 (2014), Article ID 485916, 3 pages
http://dx.doi.org/10.1155/2014/485916
Case Report

Treatment of Parturition-Induced Rupture of Pubic Symphysis after Spontaneous Vaginal Delivery

1Department of Gynecology and Obstetrics, University Hospital RWTH Aachen, 52074 Aachen, Germany
2Department of Orthopaedic Trauma, University Hospital RWTH Aachen, 52074 Aachen, Germany
3Department of Diagnostic and Interventional Radiology, University Hospital RWTH Aachen, 52074 Aachen, Germany

Received 30 October 2013; Accepted 12 December 2013; Published 16 January 2014

Academic Editors: E. Cosmi, C. Ficicioglu, G. Monni, and E. F. C. Murta

Copyright © 2014 C. Gräf et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Parturition-induced rupture of pubic symphysis is an uncommon but severe complication of delivery. Characteristic symptoms are an immediate onset of suprapubic and/or sacroiliac pain within the first 24 hours postpartum, often accompanied by an audible crack. Diagnosis can be confirmed by imaging including X-ray, Magnet Resonance Imaging (MRI), and ultrasound. However, there is no consensus on the optimal therapy. Conservative treatment is predominantly used. It has been reported that, in cases of extreme symphyseal rupture with pelvic instability or persisting pain after conservative therapy, operative treatment achieves a successful outcome. In this report, we present a case of a twenty-year-old primigravida who developed suprapubic pain after a nonoperative vaginal birth with shoulder dystocia. A rupture of pubic symphysis with a gap of 60 mm was confirmed by means of X-ray and MRI. Simultaneously, other pelvic joint injuries could be excluded. Operative treatment by an open reduction and internal plate fixation yielded excellent results.