title: Diastasis of symphysis pubis and labor: Systematic review.
abstract: Symphysis pubis diastasis (SPD) is an infrequent complication of labor that can impair womens' general health through failure of the passive stability of the pelvic girdle. Although conservative approaches are often used to decrease symptoms and interpubic separation, notably few studies have analyzed the effect of these methods on managing the symptoms of women with SPD. The purpose of this study was to review the available literature on the conservative treatment of SPD during pregnancy and labor. A computer-based search using PubMed, PEDro, and CINAHL was performed up to November 2014. We selected all studies that considered women with SPD during pregnancy or labor and treated them with conservative methods and excluded those that included surgical intervention. Eighteen studies were selected, most of which were case reports. Although the overall results of conservative treatment were unclear because of the type and design of the obtained studies, most of the studies reported bed rest in the lateral decubitus position and a pelvic girdle as basic treatments. Additionally, the few clinical trials reported recommended additional physiotherapy, including strengthening and stabilizing exercises, to reduce SPD symptoms.
authors.affiliation: Department of Rehabilitation and Physiotherapy, University Hospital Alcorcón Foundation, Madrid, Spain;
authors.forename: M Alicia
authors.initials: MA
authors.lastname: Urraca-Gesto
authors.forename: Gustavo
authors.initials: G
authors.lastname: Plaza-Manzano
authors.forename: Alejandro
authors.initials: A
authors.lastname: Ferragut-Garcías
authors.forename: Daniel
authors.initials: D
authors.lastname: Pecos-Martín
authors.forename: Tomás
authors.initials: T
authors.lastname: Gallego-Izquierdo
authors.forename: Natalia
authors.initials: N
authors.lastname: Romero-Franco
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D001510:Bed Rest; D001915:Braces; D005260:Female; D006801:Humans; D056888:Patient Positioning; D026741:Physical Therapy Modalities; D011247:Pregnancy; D046548:Pubic Symphysis Diastasis / Q000628:therapy*
chemical_list: D000700:Analgesics
keywords: SPD; conservative treatment; diastasis; exercise; interpubic gap; labor; physiotherapy; pregnancy; symphysis pubis; women’s health