title: Practical symphysiotomy: an overview.
abstract: Symphysiotomy is an alternative operative procedure where a deliberate division of symphysis pubis is carried out to facilitate delivery in cases of cephalopelvic disproportion, so as to permit the birth of baby by natural passages. Symphysiotomy results in a permanent increase in pelvic diameter (up to 1 cm) by surgically dividing the ligaments of the symphysis under local or general anaesthesia. Symphysiotomy should only be done in a established case of obstructed labour but not in anticipation of obstructed labour. This operation was reviewed in 21 cases of established obstructed labour in Silchar Medical College with little modifications of original operations. All the cases were done by subcutaneous method which is cosmetic and simple. The operation was carried out by dividing upper ligament completely and anterior arcuate ligament partially under local anaesthesia. The posterior arcuate ligament was not touched at all. None of the cases required forceps or vaccum extraction. It resulted in almost negligible complications in comparison to morbidity and mortality in primary caesarean section. Considering the usefulness of the operation it can even be started in rural hospitals by the gynaecologist if they are properly trained to do it in a justified manner in properly selected cases.
authors.affiliation: Department of Obstetrics and Gynaecology, Silchar Medical College, Silchar 788014.
authors.forename: Arun Paul
authors.initials: AP
authors.lastname: Choudhury
authors.forename: Banasree
authors.initials: B
authors.lastname: Bhadra
authors.forename: Arunava
authors.initials: A
authors.lastname: Roy
mesh_terms: D052178:Cephalopelvic Disproportion / Q000601:surgery*; D005260:Female; D006801:Humans; D007194:India; D018579:Patient Selection; D011247:Pregnancy; D012424:Rural Population; D013567:Symphysiotomy / Q000009:adverse effects / Q000379:methods*