Pubic Bone - page 2

Hi! Another one of my birdbrain questions. Is it possible for the pubic bone to seperate and cause pain from the clitoris to the top of the pubic bone? I think I'm asking that right.. well, if... Read More

  1. by   OBNURSEHEATHER
    Originally posted by CMTMom
    I had seperated symphisis pubis during my pregnancy. It isn't actually as uncommon as it seems, it is just undiagnosed a lot.
    Have you worked in OB alot to know that it's not that uncommon of an occurrence? Were you part of a study that took women with pain like this, and took x-rays to determine a false diagnosis? Just curious, as there are many years of OB experience here saying we've never had complaints like this. As nurses, we like to keep on top of our patients needs. If there's something we need to know, well, please tell us more!

    Could you describe the pain for me? It's just something I'd like to know for the future.

    Heather
    Last edit by OBNURSEHEATHER on Aug 22, '02
  2. by   delirium
    I have also followed this thread closely and would be interested in any information you have to share about this condition.

    I hadn't heard anything about it during our OB rotation. Of course we're starting high risk OB this semester so maybe it will come up then?

    Was it repaired? From your post, it seems like it happened early in your pregnancy, i.e. not at the time of delivery. Were you able to ambulate early enough after delivery to reduce the risk of postpartum complications?

    Did you have a vaginal delivery? Would an OB doc proceed with a vaginal delivery with a known separated symphysis pubis? Couldn't it compound the problem if there was CPD or shoulder dystocia?
  3. by   ~FloridaCCRN~
    My first thought when reading this thread was maybe it could be pain due to stretching of the round or broad ligament
  4. by   sunnygirl272
    Departments of Orthopedic Surgery and of Obstetrics and Gynecology, U.S. Naval Hospital, Yokosuka, Japan.

    BACKGROUND: Puerperal diastasis of the symphysis pubis is an uncommon intrapartum complication.
    Patients often respond to conservative measures.
    A small percentage of patients will develop chronic pain and require surgical treatment, which involves debridement or fusion of the symphysis pubis.
    CASE: A 33-year-old woman, gravida 1, para 0, with an uncomplicated prenatal course developed acute-onset anterior pubic pain during an otherwise normal delivery.
    This anterior pubic pain radiated to the left buttock and thigh.
    The pain persisted postpartum and was exacerbated by any movement.
    Radiographs confirmed pubic symphysis diastasis.
    The patient responded to conservative management and was essentially pain free by 10 weeks postpartum.
    CONCLUSION: The diagnosis should be considered in a patient with an acute onset of pain during delivery that does not improve postpartum.
    Language: English
  5. by   NurseDennie
    I've never worked OB, so I don't have any clinical insight into this. I had it both times I carried to term. The midwife who was teaching the Lamaze class I was in (yeah, I was HOPING for VBAC) said that she saw it from time to time.

    The pain was so bad that I could NOT walk at times. One of those episodes happened when it was time for me to leave the Lamaze class, and I couldn't.

    She said she thought it was due to ligaments loosening, and said I needed vitamin B-complex and calcium. Voila!!!! She was right, I felt ever-so-much better after I started taking them. What a RELIEF.

    Love

    Dennie

    P.S. that baby weighed 11# 12 oz, and I indeed did NOT have VBAC. That baby just went off to university, too. Snivvle, sniffle, snorrrrrk
  6. by   OBNURSEHEATHER
    Whoa! Dennie makes big babies! Don't do it that way Rebecca!

    Seriously, thanks for the info Dennie!

    Heather
  7. by   live4today
    Originally posted by NurseDennie
    ..........................

    Love

    Dennie

    P.S. that baby weighed 11# 12 oz, and I indeed did NOT have VBAC. That baby just went off to university, too. Snivvle, sniffle, snorrrrrk
    WOW!!! What a porker of a birth you had there, Dennie! :kiss It's a good thing you didn't have a VBAC. :chuckle
  8. by   NurseDennie
    LOL - She was SOOOO fat, she looked like Jabba the Hutt (well, not the ugly face, but the lack of neck)

    It was before I was a nurse. My father was diabetic, (I wasn't at the time,) so I'd been tested three times during the course of the pregnancy and no out of kilter readings. I couldn't believe a non-diabetic could have such a big kid. But hubby is 6'3" and he's just a BIG guy - that baby is 6' now, her-own-self.

    Mama bragging just for a minute - when she was first born, before I woke up! after they measured her, they flipped her over onto her tummy, and she pushed up head and shoulders off the little thingie she was on and looked around the room. The nurse said it just freaked them all out. The nurse would tell me "She's hungry, crying. Shall I bring her to you.... or just let her walk?"

    Love

    Dennie
  9. by   delirium
    Originally posted by OBNURSEHEATHER
    Whoa! Dennie makes big babies! Don't do it that way Rebecca!

    Seriously, thanks for the info Dennie!

    Heather
    Holy crap. Forget the epidural, they'd have to twilight my azz for that.
  10. by   NurseDennie
    They knocked me out. They tried the epidural, but it didn't take - just my luck. I woke up in the hall between the operating room and recovery and they told me I'd had a girl, and then they told me what she weighed and I started crying! I wanted a LITTLE baby

    Love

    Dennie
  11. by   delirium
    Originally posted by NurseDennie
    They knocked me out. They tried the epidural, but it didn't take - just my luck. I woke up in the hall between the operating room and recovery and they told me I'd had a girl, and then they told me what she weighed and I started crying! I wanted a LITTLE baby

    Love

    Dennie
    LOL!

    I always tease my cousin Cheyenne because her first child was HUGE... he weighed almost 12 lbs, and she didn't even have gestational diabetes. She's a big girl, and her husband is pretty husky, too.

    She ended up with a c-section, of course.

    I teased her that he was going to stay up in there until he learned to drive.
  12. by   bbnurse
    Years ago I think I learned that the body ordinarily provides hormones that "soften" the cartilege especially in the pubic symphasis so that there is a "give" for the passage of the head or other presenting part. So help me, I think I learned that. And also that the musculature and size of the woman, heredity and infant size affected the amount of give that the cartilage had. Most people have no problems but there are some who have a complete separation. If I remember right, the softening also affected the lower spine and had something to do with the sciatic pain related to pregnancy. BUT, GOD KNOWS, it's been a long while since I learned that. Besides which, I can not spell worth a darn tonight. Sorry about that!!! So, YES, I too have heard of this happening during the pregnancy. Not sure why I remember that though...........
  13. by   HazeK
    as L&D RN, I don't see many women prenatally or postpartum BUT....
    their MDs DO talk at the desk about interesting cases!
    Have heard over the years of several patients who had to wear very tight
    special pregnancy girdles to help stabilize their pevis due to relaxation of the
    pubic joint!
    The patients have a great deal of pain with movement and walking, so the
    girdle helps keep the joint from sliding around, being painful.

    Personally, the idea of walking around with loose pelvic joints rubbing the
    wrong way makes me have sympathy pains!

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