Severe separation of the pubic symphysis and prompt orthopedic surgical intervention.
BACKGROUND
The incidence of pubic symphysis separation during delivery is 1 in 300 to 1 in 30,000 pregnancies, and it can cause a variety of problems such as pain, bladder dysfunction, and difficulty ambulating. There is no consensus on how to treat pregnancy-related pubic symphyseal separation.


METHODS
A patient, gravida 1 para 1, who underwent vacuum-assisted vaginal delivery was found to have a severe vaginal sidewall laceration and a 6.2-cm symphyseal disruption. The patient was treated with external fixation of an open book pelvis and physical therapy. She was discharged to home on postpartum day 4, voiding spontaneously and ambulatory with a walker.


CONCLUSIONS
Aggressive treatment of severe pubic symphysis separation with external fixation resulted in early ability to ambulate, void, and care for self and baby.
Dunivan
Gena C
GC
From the Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.
Hickman
Ashley M
AM
Connolly
AnnaMarie
A
D016267:External Fixators; D005260:Female; D005592:Fracture Fixation; D006801:Humans; D011247:Pregnancy; D046548:Pubic Symphysis Diastasis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects