title: Rupture of the symphysis pubis during vaginal delivery followed by two subsequent uneventful pregnancies.
abstract: BACKGROUND
  Rupture of the symphysis pubis during vaginal delivery is a rare but debilitating complication. Factors contributing to rupture are poorly defined.
  
  
  METHODS
  A healthy primigravida suffered a rupture of her symphysis pubis during an otherwise uncomplicated vaginal delivery. She experienced significant pain and difficulty walking for 6 months after the injury. Her 5-cm symphyseal separation was managed successfully with physical therapy and activity restriction. The patient's two subsequent deliveries (one vaginal and one via cesarean delivery) were uneventful.
  
  
  CONCLUSIONS
  Severe symphyseal rupture during vaginal delivery can be managed without surgery. Risk factors for rupture are not well defined. Based on a literature review, there is a significant risk of repeat symphyseal rupture with subsequent vaginal delivery.
authors.affiliation: Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of Louisville Health Sciences Center, Louisville, Kentucky 40202, USA. pculligan@loisville.edu
authors.forename: Patrick
authors.initials: P
authors.lastname: Culligan
authors.forename: Stephanie
authors.initials: S
authors.lastname: Hill
authors.forename: Michael
authors.initials: M
authors.lastname: Heit
mesh_terms: D000328:Adult; D002585:Cesarean Section; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004420:Dystocia / Q000628:therapy*; D005260:Female; D006801:Humans; D026741:Physical Therapy Modalities; D011187:Posture; D011247:Pregnancy; D011256:Pregnancy Outcome; D011631:Pubic Symphysis / Q000293:injuries*; D012421:Rupture