title: Pubic Symphysis Rupture and Separation During Pregnancy.
abstract: OBJECTIVE
  The aim of this study was to determine the risk factors, clinical and radiologic criteria for diagnosis, and management of this unusual complication of pregnancy.
  
  
  METHODS
  A PubMed and Web of Science search was undertaken with no limitations on the number of years searched.
  
  
  RESULTS
  There were 36 publications identified, with 19 articles being the basis of this review. Multiple risk factors have been identified including multiparity, macrosomia, cephalopelvic disproportion, forceps deliveries, precipitous labor, malpresentation, prior pelvic trauma, and use of the McRoberts maneuver. The diagnosis is usually made clinically, confirmed by imaging, and considered pathological when the intrapubic gap is greater than 10 mm. Magnetic resonance imaging appears to be superior to pelvic x-ray and computed tomography scan in visualization of the bone separation. Conservative treatment remains the first choice for therapy, but women who do not respond to conservative therapy or women with large separations may need surgical stabilization with external or internal fixation.
  
  
  CONCLUSIONS
  Widening of the pubic symphysis greater than 10 mm is pathologic. The diagnosis is clinical and confirmed by imaging studies, with magnetic resonance imaging being the superior technique. Conservative treatment is the first line of therapy. Failure of conservative therapy is treated by surgical stabilization.
authors.affiliation: Medical Student.
authors.forename: Kelsey L
authors.initials: KL
authors.lastname: Shnaekel
authors.affiliation: Professor of Obstetrics/Gynecology and Maternal-Fetal Medicine.
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.affiliation: Assistant Professor of Orthopedics, Departments of Obstetrics and Gynecology and Orthopedics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR.
authors.forename: Shahryar
authors.initials: S
authors.lastname: Ahmadi
mesh_terms: D052178:Cephalopelvic Disproportion / Q000209:etiology; D036861:Delivery, Obstetric / Q000009:adverse effects*; D005260:Female; D005320:Fetal Macrosomia / Q000150:complications; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D007744:Obstetric Labor Complications / Q000209:etiology*; D009772:Obstetrical Forceps / Q000009:adverse effects; D010298:Parity; D010388:Pelvis / Q000000981:diagnostic imaging; D011247:Pregnancy; D011631:Pubic Symphysis / Q000293:injuries*; D046548:Pubic Symphysis Diastasis / Q000209:etiology* / Q000473:pathology / Q000628:therapy; D011859:Radiography; D012307:Risk Factors; D012421:Rupture / Q000209:etiology