title: [Traumatic symphyseal rupture by vaginal delivery,report of a rare case].
abstract: OBJECTIVE
  This case report draw attention symphysis pubic dysfunction and injury pelvic girdle by vaginal delivary (in our case compliated by dystokia shoulders), mainly its diagnostic, prediction and treatment.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Department of Obstetrics and Gynecology. Hospital Česká Lípa.
  
  
  METHODS
  We report a case of a 31 years old woman, who gave birth for the second time with rupture of symphysis after delivery. Childbirth was complited by dystokia shoulders and patient was treated with external fixator.
  
  
  CONCLUSIONS
  Pregnancy is a time of many physiological changes, these changes impact the musculosceletal system, which can develop a variety of problems, such es back pain, separation of the pelvic bones, transient osteoporosis and tendonitis. Effective management of treatment remains difficult to determine because of a variation in reported occurence rates and symptomatology. The most of cases are solved conservatively. This case report is extreme case of birth injury pelvic skeleton and it was necessary for surgery with an external fixator.This cases should be not to underestimate it and to treat it in interdisciplinary cooperation.
authors.forename: J
authors.initials: J
authors.lastname: Hofierková
mesh_terms: D000328:Adult; D036861:Delivery, Obstetric / Q000009:adverse effects*; D004420:Dystocia / Q000175:diagnosis; D016267:External Fixators; D005260:Female; D006801:Humans; D011247:Pregnancy; D046548:Pubic Symphysis Diastasis / Q000209:etiology* / Q000601:surgery; D012421:Rupture
keywords: diastasis of the pubic bone vaginal delivery complications.; pelvic pain; pregnancy; symphyseal rupture