Fractured Pubic Symphysis when pushing?!

Specialties Ob/Gyn

Published

Specializes in Mother/Baby;L/D.

Has anyone ever heard of a factured pubic symphysis or have actually seen one?? Another nurse was telling me that she was taking care of her postpartum pt, she had to use a walker to assist with ambulation bc during stage 2 of her labor, she fractured this area? I was told the patient was 5'4'' and the baby was almost 11 lbs.

This sounds extremely painful, I have never personally witnessed this before, and was wondereing how common this is? Does the area heal on its own? :uhoh3: THANKS!!

Up Vote Up Vote ×

This happened to me! It occured during the nvd of my 9lb 8oz baby girl. It was not confirmed until almost a year after her delivery by x-ray. I had alot of continious dull pain at the site for that entire year. I could place 2 of my fingers inside the fracture until it started to heal and fill in with new bone. It was also uncomfortable to walk for about 6 months. This happened 21 years ago and was told it was EXTREEMLY RARE and that is why the doctors kept ignoring my complaints about the pain. When I FINALLY got a doctor to listen to me and ordered the x-ray you could very clearly see the healing fracture on the pubic ramus (the thick part of the bone). So far I haven't noticed any long term consequences from this.....but was told it may not affect me until I reach my 70's-80's. My daughters birth was quite traumatic, she was precipitious-dystocia-the mid-wife had to corkscrew her out of me. I tore completely through the lady partsl wall into the peritoneum. Took the surgeon 2 hours to repair the damage. YES it does happen.

:eek:

Up Vote Up Vote ×
Specializes in High Risk In Patient OB/GYN.

Yep-it happens. Natures way of making room, I guess. (similar in that sense to a broken tailbone p delivery)

Up Vote Up Vote ×

Yep, happened to my niece 8 years ago with her first baby. She literally crawled around her house afterward.

Fast forward to 2 months ago - 2nd child - cesarean this time. Much easier recovery.

steph

Up Vote Up Vote ×

I too had never heard of this until it happened to me. It was my second baby et I had this bad feeling. I kept having a lot of pain et telling the nurse that something was wrong. Her reply to me was, "Don't expect every labor et delivery to be the same." Finally the doc came in et checked me. The baby was facing the wrong way et too late to be flipped. Doc said, "She will never deliver this baby by herself." They had to use the vacume extractor et get her out. She was 9lbs 8oz only 20 inches long. Short et fat!!:lol2: When all was said et done, I had so much pain that I could not walk. Finally after complaining et explaining enough, they did an x-ray et there was an inch gap in there!! OUCH!! I could not hardly walk. It was horrible. I think it was worse than the delivery. And I actually had a NA who told me, "We did not believe that you had that much pain until we saw the x-rays." :angryfire I could not believe it. This was my second natural delivery!! How big of a whimp are you if you have two babies naturally?

Up Vote Up Vote ×
Specializes in PICU, surgical post-op.

In a bush hospital where I worked in Zambia, there wasn't always electricity in cases where we might have needed to do a C/S. The only other option was to cut through that bone to get the baby out ... It's called a symphisiotomy and it's common practice in underdeveloped countries.

Up Vote Up Vote ×

My uncle was born at home with a doctor in 1918. He weighed 14 pounds! Grandma was probably diabetic then because she was eating a lot and not gaining enough weight (not so long after was diagnosed and went on insulin soon after it was discovered0.

The doctor "broke her pelvis" to get him out after giving her a whiff of chloroform. She was not allowed to walk for weeks.

Up Vote Up Vote ×
Specializes in OB.

It's not common. but I have seen a separated symphysis on occasion. If a patient complains of severe pain in the area of the symphysis, one trick to help her is to have her try walking backwards. I know this sounds weird, but walking backwards actually pulls the ends a little bit apart where walking forwards causes them to rub together. Backwards decreases the pain. This is a pretty good sign that she does have a separated symphysis if doing so relieves the pain. An abdominal binder wrapped very low can also help to stabilize the area.

Up Vote Up Vote ×
Specializes in ER.

Are we talking about a pubic symphysis (sp?) separation or an actual fracture? I had a separation with my last kiddo, not during labor but in the third trimester. It hurt like hell! Midwife said that it is not at all common and most often occurs as a result of tramatic injury such as a motor vehile accident. 5 years later, I still have severe pain on the first day of my period in the same area.

TL

Up Vote Up Vote ×

Ummmm, ducking my head here...:sofahider

The Pubic Symphysis is a joint not a bone...

Seperation of the public symphysis is tearing/stretching of the cartilaginous tissue that makes up the joint.

Up Vote Up Vote ×
Are we talking about a pubic symphysis (sp?) separation or an actual fracture? I had a separation with my last kiddo, not during labor but in the third trimester. It hurt like hell! Midwife said that it is not at all common and most often occurs as a result of tramatic injury such as a motor vehile accident. 5 years later, I still have severe pain on the first day of my period in the same area.

TL

Mine was the seperation of the pubic symphasis I was talking about. Not a broken bone. But hurts like one though!! Sorry that you still hurt but glad to know that it is not just me. My kid is over two years et sometimes mine hurts.

Up Vote Up Vote ×

This happens and it happened to me!! 3 years ago I lady partslly delivered full term twins with an epidural. The nurses kept coming in and making me get up to go to the restroom and walk around and everytime I could get up and try to walk I would faint. They suspected I needed more fluids in my IV and kept pumping me full of them. the next day once the epidural completely wore off and I then couldn't even swing my legs around to get out of bed, they thought I was "crazy". Totally telling me, "oh hunny, you just had two babies you will be sore, come on and get up." I have a very high pain tolerance and knew something wasn't right. I literally COULD NOT walk. Other than the fainiting and pain, I was so frustrated wondering why I couldn't walk. Later that day, another nurse came in and helped me up. She asked me to walk backwards. I was very upset and continued to tell her I can't walk. I finally tried and I could do it. Now don't get me wrong it wasn't a full walk, more like an extremely painful drag of my legs backwards. She was so excited. She said she had been a nurse for 25 years, had heard of this, but never seen it! She explained that it is sort of like when you break your tailbone, you can "walk" forward, but not backward. This on the other hand is the opposite. I was sent home with a much needed walker and walking backwards was the only mobility I had (with newborn twins) 6 weeks of being unable to move and walk.

Up Vote Up Vote ×
+ Add a Comment