Symphysitis where it hurts. Symphysitis is an unpleasant companion to pregnancy. Diagnosis in pregnant women
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One of the most well-known skeletal pathologies during pregnancy can be considered symphysitis - damage to the pubic joint (or symphysis). You need to know that if symphysitis is detected during pregnancy with the first child, then it is almost always detected in subsequent pregnancies.
What is symphysitis - definition of the concept, terms
Symphysis In medical practice, it is customary to call the area where the articulation of the pubic bones occurs.
As the pregnant uterus grows, this area is stretched (due to relaxation of the ligaments), which subsequently leads to increased mobility of the joint.
There is no need to worry, because this is a physiological process that accompanies labor.
Only in certain situations can the joint become greatly softened, becoming abnormally mobile, which causes manifestations symphysitis.
Symphysitis has clinical features, in which the affected area swells, discomfort and pain appear in the perineal area. Such symptoms characterize mainly the second half of gestation, when walking and climbing stairs cause difficulty, and turning to one side from a lying position causes pain.
Causes of symphysitis in pregnant women and predisposing factors
This pathology can be detected when softening occurs in the area where the pubic bones of the pelvis connect. In a non-pregnant woman, the pubic bones that form the joint are connected to each other firmly and motionlessly.
Symphysitis, a strong degree of divergence of the pubic bones at the joint
During pregnancy, the state of the ligamentous apparatus is responsible relaxin hormone(it is released in increased concentrations). Due to its effect on the tissues, they soften, as a result of which the joint becomes mobile.
Nowadays, the causes have not yet been identified and the conditions due to which symphysitis appears in women during gestation have not yet been fully studied.
When pregnancy occurs, some women experience a slight stretching of the joint, but some patients experience symphysitis with the most striking clinical manifestations, which can then be observed for quite a long time in women who have given birth.
There are different factors and hypotheses regarding the development of symphysitis in pregnant women
- Firstly, articulation may be adversely affected by decrease in calcium content in the female body, so bones may contain less calcium than they should.
- Secondly, symphysitis may be associated with an increase in the amount of the hormone relaxin in the body. Therefore, the joint stretches excessively, swells, and characteristic symptoms appear.
- In addition, special attention is paid to predisposing factors, these include the existence bone and joint pathology before pregnancy, the anatomical structure of the female body with its individual characteristics, genetic predisposition.
Today there is no clear answer as to why this disease appears and develops in women who are carrying a child.
Why symphysitis appears in pregnant women has not been fully studied, but doctors express different thoughts on this issue
- A decrease in the amount of calcium in the female body during gestation.
- Hypovitaminosis for many substances.
- An excess of the hormone relaxin, which is detected quite often when carrying a child. Excessive levels of this hormone soften the ligaments. Up to a certain point, the symphysis gradually stretches as the fetus grows, and then a crack forms on it, which leads to rupture of the articulation of the womb during natural childbirth.
- Hereditary predisposition.
- Disorders of the musculoskeletal system during gestation.
Symptoms of symphysitis during pregnancy - how to notice and distinguish from other dangerous conditions?
After the fourth month of development, the fetal weight quickly increases, the uterus greatly increases, and clinical signs of pathology begin to appear.
Symphysitis manifests itself most often in the last month of pregnancy. It is characterized by the appearance of swelling at the junction of the pubic bones, a crunching sound when palpated, and severe pain is felt in the perineal area.
The pain syndrome is also localized in the pelvis, tailbone and hips. If the position of the body changes quickly - when a woman climbs the stairs, gets up from a chair, turns around - then the intensity of the pain sharply increases.
When a pregnant woman takes a lying position, then if there are manifestations of symphysitis, she cannot lift her straightened leg, plus a “duck gait” appears while walking, and if she climbs the stairs, she feels heaviness.
With the further development of pregnancy, the leading symptoms of symphysitis increase, the pain syndrome becomes more distinct - therefore, even at rest, pain begins to bother you.
Signs of symphysitis in pregnant women, when you need to see a doctor
To prevent the situation from getting worse, you need to carefully monitor your body, since when a woman is carrying a child, she must take care not only of her health, but also of the health of the baby, who has not yet been born.
Signs and symptoms of symphysitis during pregnancy:
- In the place where the pubic bones connect, the inflammatory process increases, manifesting itself first as a small and then increasing swelling.
- A pregnant woman develops a “duck walk.”
- If you palpate the pubic area, a sharp piercing pain occurs in this place and clicks are heard when pressed.
- When the position of the body changes, pain also occurs.
- A woman in this position has a forced mincing gait so that the position of the hip area practically does not move.
- A feeling of heaviness occurs in the abdomen, in its lower part.
- There is a problem with raising a straight leg.
- When climbing stairs, discomfort and pain in the hip occur.
During pregnancy, the signs of symphysitis become more pronounced, and the pain syndrome is more pronounced. A pregnant woman experiences pain when she moves, when she is at rest, when she sits and lies down.
Complaints usually appear towards the end of the last trimester, the listed symptoms clearly appear, in the second they appear quite rarely.
Complications of symphysitis during pregnancy - is the disease dangerous?
It is necessary to familiarize yourself with all the threats of symphysitis, what danger the pregnant woman and the fetus are exposed to:
Like any other pathology, symphysitis is an alarming sign for a pregnant woman because serious consequences may occur due to excessive increasing the mobility of the symphysis pubis.
The second half of pregnancy is accompanied by discomfort and pain that torment the woman. : that is, whether the woman will give birth on her own, or whether she will be indicated for a caesarean section.
In addition to the presence of symphysitis itself, it is necessary to take into account how the pregnancy is proceeding, whether there is toxicosis, gestosis, what the size of the fetus is, how many births there have been before, how they proceeded - in general, all the points that affect childbirth.
The effect of syphysitis on the condition of the fetus
The baby is not directly threatened by symphysitis.
But the pregnant woman emotional state worsens when it is constantly accompanied by pain and discomfort in the perineal area. When an expectant mother is constantly exposed to stress, this has a negative impact on the condition of the fetus.
Most often, this pathology is diagnosed at an appointment by an obstetrician-gynecologist in one of the last three months of pregnancy.
During gestation, a woman experiences a burning sensation in the pubic area, pain in the pelvis and projections of its organs, so the entire body should be examined more carefully.
The danger of symphysitis during childbirth and after pregnancy - all possible risks
This disease is not harmless, it is manifested by inflammation of the bone structures of the pubis, its anatomical changes: bones and ligaments are weakened and loosened, in the future it is possible divergence and then rupture of the symphysis.
A woman is subjected to severe suffering when such a pathology occurs. The degree of development of the pathology, together with other parameters - for example, the weight of the child, the number of pregnancies that have occurred before, the course of the current pregnancy - can affect method of delivery.
Update: October 2018
Pregnancy is a special condition of a woman in which all organs and tissues undergo changes. The musculoskeletal system of the expectant mother is no exception. Very noticeable changes occur in the pelvic bones, which form a “channel” for the birth of a baby.
How does the female pelvis work?
The pelvis is a closed ring consisting of the pelvic bones, sacrum and coccyx. The pelvic bones, in turn, consist of the pubic, ischial and ilium bones. The female pelvis, in addition to supporting the internal organs, has a very important function: carrying the child during childbirth. In this regard, all ligaments and cartilages of the pelvis have a peculiarity: they “soften”. The pubic symphysis, where the cartilage is located, also becomes more mobile and soft under the influence of a special hormone - relaxin. This allows you to slightly adjust the size of the pelvis to the circumference of the baby's head.
What is symphysitis?
Literally, symphysitis during pregnancy is inflammation of the pubic symphysis. It doesn't happen very often. While waiting for a baby, it is more correct to use the term “symphysiopathy.”
- It means excessive softening of the cartilage, an increase in the distance between the bones by more than 0.5 cm.
- In a non-pregnant woman, the distance between the pubic bones is approximately 0.2 cm.
- At the age of 18-20 years, it may be slightly increased (up to 0.6 cm), then gradually decreases.
If at the time of birth the pubic bones still diverge, sometimes with rupture of the symphysis, this is called symphysiolysis. Sometimes an inflammatory process begins at the point of their divergence. These are symphysites.
Symptoms of symphysitis during pregnancy
The process of excessive divergence of the symphysis pubis, and even more so inflammation of the symphysis, always reveals itself with the following symptoms:
- Shooting or pulling pain in the pubic area
- Increased pain with physical activity, especially when abducting the hip to the side
- Pain spreading to the back, thigh or abdomen
- Pain in the symphysis pubis upon palpation
- Pain during intercourse
- Change in gait (“duck”, “waddle”)
- Relief or disappearance of pain at rest
- Possible defecation problems
It must be remembered that mild pain in the pubis is the norm during pregnancy; this happens in 50% of women. Sprained ligaments and softening of the symphysis lead to some discomfort, especially in the last weeks before childbirth. In such cases, expectant mothers just need to be patient. Only the appearance of severe, unbearable pain, as well as loss of range of motion and sleep disturbance are considered symptoms of symphysitis during pregnancy.
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Causes of symphysiopathy
Not all pregnant women experience pronounced changes in the pubic symphysis and pain. Certain factors predispose to this.
- Heredity
It is believed that the risk of symphysis dehiscence is greater if close relatives had similar problems during pregnancy
- Features of connective tissue
Congenital weakness of ligaments and connective tissue in general is a rather controversial issue in medicine. This condition is diagnosed much more often than it actually is. Children with this feature are more likely to experience dislocations and subluxations; there may be problems with heart valves, prolapse of the kidneys and other organs, and joint hypermobility. During pregnancy, women with connective tissue dysplasia may experience more discomfort in the ligament area.
- Calcium deficiency and vitamin D deficiency
Often, although not in all cases, it leads to excessive softening of the symphysis. This factor may be indicated by brittle hair, splitting nails, and fractures in pregnant women.
- Kidney diseases
It is believed that kidney diseases (for example, pyelonephritis) lead to increased excretion of protein and minerals from the body along with urine. This promotes more intense softening and divergence of the symphysis.
- Previous pelvic injuries
- Multiple births
Degrees of symphysiopathy
Depending on the distance to which the pubic bones have diverged, symphysiopathies come in three degrees:
- 1st degree – from 0.5 to 0.9 cm
- 2nd degree - from 1 to 2 cm
- 3rd degree - over 2 cm
This distance is determined using ultrasound. In addition, upon palpation, the doctor may detect softening of the cartilage and instability of the pelvic bones.
The effect of symphysitis on pregnancy and childbirth
Symphysiopathy itself does not affect pregnancy. It only worsens the well-being of the expectant mother. But excessive stretching of the symphysis pubis during pregnancy can thin it so much that cartilage ruptures during childbirth (symphysiolysis).
This is an unpleasant injury that results in disability for several months. The risk of rupture of the joint increases if the woman’s pelvis is narrow and the child is large (more than 4 kg). Therefore, doctors often recommend a cesarean section for symphysiopathy of degrees 2 and 3, as well as for severe pain and. This reduces maternal injuries significantly.
How does a symphysis rupture manifest itself?
Symphysiolysis makes itself felt before, during, or immediately after childbirth. A postpartum woman cannot raise her legs, get out of bed on her own (only sideways), climb stairs, and sometimes even move her limbs to the required extent. Any physical activity causes pain.
Why is a symphysis rupture dangerous?
Symphysiopathy, although it causes a lot of inconvenience, does not threaten health and life. But a rupture of the symphysis pubis during childbirth is already an injury, a fracture of the pelvis.
- If the bones are separated by 2 cm, then such a fracture is stable and rarely causes complications.
- And if the distance between the edges of the ruptured symphysis is 5 cm or more, this is a direct danger to health.
The edges of the bones can damage the urethra, bladder, and clitoris. Hemorrhages may occur in the joint area, which will subsequently lead to arthritis. Therefore, such tears must be treated with surgery. Fortunately, such cases are very rare.
Case study: A young (26 years old) multiparous woman was admitted to the maternity ward with complaints of pushing. From the anamnesis it is known that the second birth, on time, began about 5 hours ago. My water broke an hour ago in the ambulance. An obstetric examination revealed: the opening of the cervix is almost complete, the head is pressed to the entrance to the pelvis, a sagittal suture in the right oblique size, a small fontanel on the left anteriorly. An hour later, a live, full-term boy was born without visible malformations. But only the next day, during a round, my colleague and I discovered that the postpartum woman had a duck’s gait and identified complaints of pain in the pubic area. After consultation with a surgeon, a diagnosis was made: divergence of the symphysis pubis. The child was discharged home on the 5th day under the supervision of his father and grandmothers, and the woman was transferred to the gynecology department, where she spent 1.5 months lying down with her legs bent and spread apart at the knees. It is difficult to say what led to such a condition; with timely diagnosis (ultrasound), a cesarean section is indicated for divergence of the symphysis pubis and such consequences could have been avoided. The postpartum woman was discharged with recovery after an X-ray examination (obstetrician-gynecologist Anna Sozinova).
Diagnostics
If there are complaints of pain and swelling in the pubic area, as well as difficulty in movement, all pregnant women are advised to undergo an examination.
- Ultrasonography
Ultrasound of the symphysis pubis allows you to assess the distance between the bones of the pubis, as well as see indirect signs of inflammation. But often, with a small discrepancy, a woman experiences unbearable pain. Conversely, with a large distance between the bones, complaints are minimal. Thus, the ultrasound report will indicate only the amount of discrepancy of the pubic symphysis. And the final diagnosis will also take into account the severity of symptoms.
- X-ray of the pelvic bones
This method is most often used after childbirth to diagnose symphysis rupture and monitor treatment. Pregnant women undergo X-ray pelvimetry (measurement of the pelvis) somewhat less frequently. It allows you to further assess the correspondence between the size of the fetal head and the circumference of the pelvis.
- CT and MRI
More accurate methods are used after childbirth. This helps to monitor the effectiveness of treatment, as well as identify other pathologies in the pelvic area.
Differential diagnosis
Often, pain similar to the sensations of symphysitis is caused by completely different conditions. Therefore, it is extremely important to tell your gynecologist if you experience pain. The doctor will examine you and prescribe additional tests. Other causes of pubic pain:
Sciatica (sciatica)
This is pain in the area of the sciatic nerve. Unpleasant sensations can spread from the groin and tailbone along the leg to the shin. This symptom may be a sign of diseases such as arthritis, arthrosis, pelvic tumors and muscle damage.
Lumbago
This is acute back pain associated with spinal pathology (osteochondrosis, intervertebral hernia). Painful sensations can radiate to the leg, groin, abdomen, and often lead to urination and defecation disorders.
Infections of the genital and urinary tract
This is another cause of pain in the pubic area. Cystitis caused by E. coli or sexually transmitted infections often manifests itself as burning, stinging and tingling in the groin. Considering that during pregnancy the tendency to cystitis increases, if such pain appears, you need to be examined for infections.
Osteomyelitis and other bone diseases (tuberculous lesions)
They are quite rare. But they cannot be discounted. Women with a history of tuberculosis or who have suffered pelvic trauma require special attention.
To exclude or confirm the above diagnoses, it is enough to perform an ultrasound, x-ray, as well as smears and cultures for infections. Read more about.
Treatment of symphysitis
Symphysiopathy (softening of the symphysis pubis) is a phenomenon characteristic only of pregnancy. Therefore, 4-6 months after birth, all symptoms usually disappear. Sometimes pain in the pubic area can persist for up to 1 year. Medical attention is not required in such situations. If symphysiolysis (rupture of the pubic symphysis) has occurred, then treatment will depend on its degree.
Treatment of symphysiopathy during pregnancy
You can alleviate the symptoms of symphysis dehiscence by following simple recommendations:
- Limiting the duration of walking, sitting in one place and climbing stairs
- Even distribution of body weight in a stationary position (standing, sitting)
- Eating foods rich in calcium. In some cases, your doctor may prescribe calcium supplements. Taking supplements should be under the supervision of a specialist, since an excess of this microelement can harm the fetus, especially in the 3rd trimester. In the last weeks before childbirth, calcium intake is not recommended.
- Body weight control. Excess weight increases the load on joints and ligaments, causing pain.
- Wearing a prenatal bandage from 25-28 weeks of pregnancy. Special abdominal support reduces pressure on the symphysis and reduces pain.
Treatment of symphysitis during pregnancy is controlled by an obstetrician-gynecologist and an orthopedist-traumatologist. Consultation with a physiotherapist and neurologist is often necessary.
Exercises to relieve pain:
Cat pose - standing on your knees and elbows, you need to straighten your back and shoulders. Then arch your back while lowering your head down, tensing your abdominal muscles. Repeat these steps several times.
Raising the pelvis - while lying on your back, you need to bend your knees. Then slowly raise your pelvis, fix it at the top point and lower it. Repeat the exercise several times.
Kegel exercises- exercises that simulate the retention and release of a stream of urine strengthen the pelvic floor muscles. This can somewhat reduce pelvic instability and relieve stress on the pubic bones.
All physical exercises can be performed if they do not cause increased pain and if there are no medical contraindications.
Treatment of symphysiolysis after childbirth
- Anesthesia
Typically, substances from the group of nonsteroidal anti-inflammatory drugs (NSAIDs) are used to relieve pain. These are well-known and other painkillers. They should be used only in case of severe pain, since uncontrolled and long-term use of NSAIDs leads to the formation of stomach ulcers and liver dysfunction. In addition, it is necessary to consult a doctor when breastfeeding a child. Not all painkillers are safe for your baby.
- Gentle mode
When the bones are not too far apart, sometimes it is enough to reduce physical activity using canes and other special means.
- Bandages
Wearing a bandage that grips the trochanters of the femur can reduce pain and reduce the risk of further separation. This accelerates the fusion of the symphysis.
- Physiotherapy
Some types of physiotherapy (for example,) are used to accelerate the healing of the symphysis. This method helps only in combination with bed rest and fixation of the pelvic bones.
- Bed rest
In cases of severe dehiscence and rupture of the symphysis, strict bed rest is indicated. To speed up fusion, use a special hammock with cross-hung weights. This device brings the pubic bones together.
- Treatment with controlled pelvic girdle
To enhance the effect of the hammock, a special pelvic belt is used. It has several straps to which weights are attached. With their help, the tension of one or another part of the belt is regulated, which contributes to the rapid healing of the gap.
- Surgical treatment of old ruptures
If for some reason treatment of symphysitis was not carried out, and an old rupture reminds of itself with pain and limitation of movements, then they resort to surgery. During surgery, rods and plastic materials are used to restore the integrity of the pelvis.
Prevention of symphysitis
It is impossible to prevent the occurrence of symphysiopathy, since there are no precisely established causes of this condition. But by following these recommendations, you can reduce the risk of symphysis rupture and avoid long-term treatment.
- Careful pregnancy planning (examination for infections, thyroid pathology)
- Adequate nutrition during the planning period and throughout pregnancy and lactation
- Taking additional medications if necessary (calcium, iron,)
- Ultrasound of the fetus in the 3rd trimester to determine the expected weight of the child
- Controlling glucose levels in diabetes mellitus (since this disease is accompanied by the birth of large children weighing more than 4.5 kg)
- It is necessary to inform the doctor about all injuries, fractures and problems during previous births.
- Contact a specialist if you experience pain in the pubic area, swelling and limited movement
- Consultation with a specialist on the method of delivery (in some situations, caesarean section can avoid severe pelvic injuries).
What it is?
The symphysis is a fibrous or cartilaginous transitional connection between the bones of the skeleton, which is present in the area of the pubis, chin, sacrum, intervertebral discs and sternum.
It should be in a stationary, fixed state, but during pregnancy the symphysis of the pubic symphysis experiences heavy loads. As a result, the connection becomes mobile and sometimes gives the pregnant woman a lot of inconvenience and pain. Moreover, the lower the fetus is located, the greater the pressure its weight exerts on the pubic bones.
In medical practice, this problem is called “symphysitis.” However, this diagnosis is not always given to all women expecting a child.
The fact is that the mobility of the pubic bones is a natural state during pregnancy, because the mother’s body must prepare for childbirth and provide the baby with an unhindered exit from the mother’s womb.
Therefore, symphysitis during pregnancy is diagnosed only in cases where the discrepancy of the bones exceeds the norm, and the pubic symphysis itself becomes swollen.
Symptoms of symphysitis during pregnancy
The first trimester of pregnancy does not yet have any effect on the bones of the womb. The fetus is still small, the uterus is only slightly enlarged, so the symphysis is in relative stability and peace.
From the middle of the second trimester, the bones of the pelvic floor begin to experience stress, but the divergence of the symphysis pubis rarely begins earlier than the fifth month of pregnancy. From the 20th week, signs of symphysitis make themselves felt and worsen as the period increases.
- Pain in the pubic area almost always has a pulling, aching character. They intensify when climbing stairs, walking for a long time and subside if the expectant mother is at rest. If the stage of symphysitis is advanced, then the pain persists throughout the day and tends to intensify. The nature of the manifestation also changes - against the background of constant aching pain, lumbago and a feeling of pinching appear.
- Swelling – localized in the pubic area. As the disease progresses, the size of the swollen area increases, and the swelling itself becomes more obvious and painful to the touch. It means the presence of an inflammatory process in the symphysis of the pubic symphysis.
- Heaviness in the lower abdomen is caused by the process of bone separation, swelling and a rush of blood to the pelvis. In some cases, a pregnant woman may attribute this symptom to a threat of miscarriage and go to the hospital. Heaviness in the lower abdomen increases if a woman takes an upright position and decreases at rest.
- A sharp deterioration in the condition during exercise - here we mean the load in the form of climbing stairs, lifting legs in a lying or standing position. In advanced stages of symphysitis, clicking sounds may be heard, and the pain during exertion becomes sharp and severe. After stopping exercise for an hour, swelling of the pubic area may increase.
Obvious signs of the disease appear mainly in the last two months of pregnancy. You cannot tolerate pain; you must immediately consult a doctor.
Symphysitis does not pose a threat to the life of the fetus, but can cause disability for the mother after childbirth.
Causes of symphysitis
A number of factors may contribute to the cause of symphysitis during pregnancy, which manifests itself in the second and third trimesters:
1) Lack of calcium – a growing fetus has a greater need for calcium, which it takes from the mother’s body. When the deficiency of this substance becomes critical, a woman begins to have problems with the skeletal system and joints. This situation can become a provoking factor in the development of symphysitis in the later stages.
2) Musculoskeletal disorders - pregnant women with such diseases are at risk of excessive divergence of the bones of the symphysis pubis. An example would be expectant mothers suffering from complex forms of cerebral palsy (tetraparesis, lower paraparesis).
The movement of such patients is associated with certain difficulties, and posture, for physiological reasons, cannot be straight.
This leads to an uneven distribution of the load given by the growing fetus, causing the pubic bones to diverge to a distance exceeding the permissible norm.
3) High levels of relaxin - during pregnancy, especially as labor approaches, the ovaries and placenta begin to actively produce this hormone, which is necessary for a woman to bear the birth of her baby.
In some cases, the production of relaxin is excessive, so the ligaments become more elastic and the bones become more fragile. The symphysis also suffers, the consistency of which becomes softer.
Degrees of symphysitis during pregnancy, characteristic symptoms
Upon examination, the doctor can not only make a diagnosis, but also determine the stages of the disease. After all, symphysitis is a serious pathology of a woman’s skeletal system and its treatment will depend on how severe the situation is in a particular case.
Symphysitis 1st degree suggests that the distance between the pubic bones is 5 – 9 mm. A pregnant woman may experience the following symptoms:
- Nagging pain in the pubic area when walking for a long time.
- Slight swelling.
- Unpleasant sensations in the lower abdomen after climbing stairs
The first degree is considered mild, it is not dangerous to the mother’s health, and all inconveniences disappear if the woman reduces the load or rests. In some patients, symphysitis does not progress, but medical supervision is still necessary in order to correctly assess the situation and not miss the moment if the distance between the pubic bones begins to increase.
Symphysitis 2nd degree suggests that the gaps inside the symphysis pubis have increased to 15–20 mm. The following symptoms correspond to this:
- The pain is constantly present: at rest it becomes less noticeable, and during exercise it becomes more pronounced.
- Noticeable swelling in the pubic area.
- Heaviness in the lower abdomen that accompanies a pregnant woman constantly, with the exception of the time when she is in a supine position.
In the second stage, natural childbirth is in question - the risk of rupture of the symphysis pubis is too great. Most maternity hospitals will prefer to perform a caesarean section in this case, and only specialized research institutes equipped with advanced technologies, equipment and highly qualified doctors will dare to allow a woman to give birth naturally.
Symphysitis 3rd degree is considered the most severe and involves the divergence of the pubic bones by a distance exceeding 20 mm. The symptoms are pronounced:
- The pain is aching, sometimes shooting into the leg.
- Extensive swelling.
- Constant heaviness in the lower abdomen.
- Clicking when palpating the affected area.
The third degree means that the birth will be carried out only by caesarean section, and until this moment the patient is prescribed complete rest and bed rest.
Each stage of symphysitis during pregnancy has its own symptoms, but you cannot determine the degree of development of the disease yourself - only a doctor should do this.
Symphysitis after childbirth
Excessive divergence of the pubic bones can make itself felt not only during pregnancy, but also in the postpartum period. This can happen for several reasons:
- Mild symphysitis diagnosed during pregnancy. In this case, natural childbirth is not prohibited, but sometimes it can provoke a worsening of the disease, especially if the fetus was large.
- During pregnancy there was stage 2 symphysitis, but for some reason the doctors decided to let the woman have a natural birth. Even with a normal weight of the child, this is often the reason for the worsening of the disease in the postpartum period.
- There was no divergence of the pubic bones during pregnancy, but the woman’s body lacked calcium or during childbirth there was a large release of the hormone relaxin, which led to the development of the disease after the baby was born.
It is important to visit a doctor in time, because grades 2 and 3 symphysitis after childbirth can worsen so much that this will lead to disability and the preservation of a “duck gait” for life.
Therapy for symphysitis has 3 main goals: reducing pain, eliminating factors that provoke further separation of the bones and returning the bones of the pubic symphysis to their original place.
- Pain relief – medications are prescribed in injections or tablets to reduce pain. Among them: No-shpa, Ketorol, Baralgin, Paracetamol. To avoid addiction to the drugs, they are recommended to be taken only if a woman has to spend a lot of time on her feet.
- Change of regimen - the patient, depending on the severity of symphysitis, will be prescribed either bed rest or semi-bed rest. If a mild degree of the disease is diagnosed, the doctor will advise reducing daily exercise. A change in mode is necessary so that the symphysis pubis is in relative peace.
- Restoring the previous position of the bones - postpartum symphysitis - will most likely require wearing a special bandage, the effect of which will be aimed at reducing the gap between the bones. At stage 3 of the disease, in addition to a bandage, the doctor will prescribe a cane or crutches.
- Physiotherapy – electrophoresis, massage are used, as well as a course of exercises that will be individual for each patient. CMT (current muscle stimulation) can be used to connect bones, although one of its side effects will be a temporary feeling of stiffness in the thigh muscles.
Symphysitis is a disease that is better to begin treating immediately than to wait for a critical condition. After all, not only the woman’s movement, but also her ability to carry another pregnancy will largely depend on the outcome of treatment.
Symphysitis during pregnancy is a common pathology that affects approximately half of the female population during pregnancy. In addition, it is worth considering that if during the first pregnancy a diagnosis of “symphysitis” was made, then in the case of a subsequent pregnancy it will also be present.
In medical practice, the concept of “symphysis” is the articulation of the pubic bones. During pregnancy and growth of the uterus, stretching of this area is observed, which subsequently provokes an increase in the mobility of the joint.
There is no need to worry, because such a process is physiological, necessary for labor. Symphysitis is noted due to the development of excessive mobility due to severe softening of the joint.
As a result, symphysitis is characterized by the appearance of such clinical manifestations as pain, discomfort in the perineal area and swelling of the joint.
Similar symptoms are mainly observed starting from the second half of pregnancy, when difficulty appears when climbing stairs, walking and turning on one side in a supine position.
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Causes of symphysitis during pregnancy
This pathology is associated with softening of the articulation area between the pubic bones of the pelvis. Outside of pregnancy, the symphysis is an almost immobile connection of the pubic bones, forming a joint.
The hormone relaxin plays an important role in the normal maintenance of joint tone. Under its influence, tissue softens, as a result of which the joint acquires greater mobility.
The causes of symphysitis during pregnancy have not been fully studied to date. After all, during pregnancy, one woman’s joint stretches slightly, while others suffer from symphysitis and its clinical manifestations. In addition, he can accompany a woman who has already given birth for a long time.
There are various assumptions and causes of symphysitis during pregnancy. Firstly, an insufficient amount of calcium in a pregnant woman may have a negative effect on the joints, resulting in low levels of calcium in the bones.
Secondly, it is possible that symphysitis is associated with the hormone relaxin and its levels are increased in the body. As a result, excessive stretching of the joint occurs, its swelling and the appearance of characteristic symptoms.
The rest of the group of causes is occupied by predisposing factors, for example, the presence of pathology of bones and joints even before pregnancy, the individual anatomical features of the structure of each woman, or genetic predisposition.
Today, it is impossible to say unequivocally why this disease occurs and develops in women carrying a child. The causes of symphysitis during pregnancy are not fully understood, but doctors nevertheless express certain thoughts on this matter.
- Low calcium levels in the mother's body.
- Avitaminosis.
- An excess of the hormone relaxin, which is quite often observed during pregnancy. Excessive presence of this hormone leads to softening of bone tissue. The growth of the fetus leads to stretching of the symphysis, and after a certain point, a crack appears on it, which provokes rupture of the articulation of the womb during spontaneous labor.
- Hereditary predisposition.
- The pregnant woman has a history of musculoskeletal disorders.
Symptoms of symphysitis during pregnancy
Most often, the clinical manifestations of the pathology begin to worry after the 4th month of pregnancy, when the fetus begins to rapidly gain weight and the uterus increases significantly.
Symptoms of symphysitis during pregnancy appear most intensely in the last months. It is characterized by an increase in swelling of the joint area, intense pain in the perineal area, as well as a crunching sound when palpating the pubic joint.
In addition, it should be noted that the pain syndrome extends to the pelvic region, tailbone and hips. An increase in pain intensity is observed with rapid changes of position, for example, when turning, rising from a chair or climbing stairs.
Symptoms of symphysitis during pregnancy do not allow you to raise your straight leg in a supine position, provide a “duck” gait and a feeling of heaviness when climbing stairs.
As the duration of pregnancy increases, symphysitis further progresses, in which the pain syndrome is disturbing even at rest.
In order not to aggravate the situation, it is necessary to be very attentive to your body, because during pregnancy, a woman is responsible not only for her health, but also for the health of her unborn child. Therefore, it is worth knowing the symptoms of symphysitis during pregnancy, if you find them in yourself, you must inform your doctor observing the pregnancy.
- Mostly, these symptoms appear in women in the third trimester of pregnancy. During the second trimester it is quite rare.
- In the area of the pubic junction, first slight and then increasing swelling begins to appear - a sign of an inflammatory process.
- A pregnant woman gets a so-called “duck” gait.
- When palpating this area, the woman feels a sharp piercing pain. Clicking sounds may be heard when pressing.
- Painful sensations also occur to women when changing body position.
- The pregnant woman begins to intuitively mince when walking, minimizing a sharp change in the position of the hip area.
- Feeling of heaviness in the lower abdomen.
- A significant problem is the need to raise the straightened leg.
- When climbing stairs, a pregnant woman feels discomfort and pain in the hip area.
Symptoms of symphysitis during pregnancy tend to progress and over time the pain becomes even more pronounced. The pain will begin to haunt the woman not only during movement, but also during the period of rest, when she sits or lies quietly on the sofa.
Why is symphysitis dangerous during pregnancy?
In order to fully understand all the threats of symphysitis, it is necessary to separately highlight the danger to the pregnant woman and the fetus. So, why is symphysitis dangerous during pregnancy for the expectant mother?
It is impossible to say for sure that this pathology is absolutely safe for a pregnant woman, since an excessive increase in joint mobility can lead to serious consequences.
Of course, it is worth mentioning the discomfort and pain that torment a pregnant woman after the 4-5th month of gestation. In addition, the choice of delivery route depends on the degree of activity of symphysitis: cesarean section or through the natural birth canal.
In addition to symphysitis, one should take into account the course of pregnancy itself, the presence of toxicosis, gestosis, the size of the fetus, the presence and number of previous births, in general, all factors that influence the course of labor.
How dangerous is symphysitis during pregnancy for the fetus? For a baby, symphysitis does not pose any threat. However, one should not forget about the emotional state of a pregnant woman in the presence of constant pain and discomfort in the perineal area. All stressful situations of the expectant mother negatively affect the condition of the fetus.
In most cases, this pathology is diagnosed at an appointment with an obstetrician-gynecologist and, as a rule, in the third trimester of pregnancy. If a pregnant woman begins to complain of an unpleasant burning sensation in the pubic area, pain symptoms of the pelvic organs, it is worth paying more attention to checking the woman’s body for symphysitis. Why is symphysitis dangerous during pregnancy? This disease cannot be called completely harmless, because it is caused not only by inflammation of the pubic area, but also by the subsequent weakening and loosening of its structure, which over time can lead to divergence and then rupture of the symphysis.
This development of pathology brings quite severe suffering to the woman. The degree of pathology, as well as other parameters (weight of the baby, number of previous births, course of pregnancy), can significantly influence the question of how a pregnant woman will give birth: independently, naturally, or will have to resort to a cesarean section.
If a pregnant woman enters a gynecological clinic for childbirth with such a diagnosis, the obstetrician-gynecologist must be aware of the presence of such a diagnosis in the woman in labor. After all, the presence of a woman’s history of symphysitis significantly increases the risk of ruptures of the pelvic joint during obstetrics. Such a nuisance, to put it mildly, is fraught with a long postpartum recovery period, as well as bed rest, which usually lasts about two weeks.
Having a newly born child in your arms, performing the necessary therapeutic exercises, visiting various specialists is not the best additional burden on a woman who has just undergone childbirth. Knowing this, not a single qualified specialist would risk allowing a woman to have a natural birth. Therefore, symphysitis is an almost guaranteed referral for a cesarean section. A doctor can take a risk and allow a woman to give birth naturally only if the crack in the womb is no more than ten millimeters apart, the baby is small, and the size and location of the pelvic bones is within normal limits. During the passage of the birth canal, the child does not experience significant discomfort with this pathology.
Diagnosis of symphysitis during pregnancy
Over time during pregnancy, the fetus begins to rapidly gain weight, starting from the 5th month. In addition, the uterus also increases significantly in size, as a result of which this combination provokes an increase in the stretching of the symphysis pubis.
Diagnosis of symphysitis during pregnancy involves asking the woman about her symptoms and the course of the disease. Thus, characteristic of symphysitis is pain, first when walking, acquiring a “duck” gait, when climbing stairs, and then at rest.
In addition, the pregnant woman notes pain and discomfort when palpating the pubic joint, which, as the pathology progresses, increases in size due to swelling.
A full diagnosis of symphysitis during pregnancy is difficult, since X-ray examination is not recommended. As a result, the doctor only has access to an objective examination and palpation of the painful area.
Sometimes computed tomography or magnetic resonance imaging is allowed, but only for health reasons. Assessing the severity of symphysitis is necessary to determine the tactics of labor and treatment of a pregnant woman.
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Symphysitis during pregnancy on ultrasound
In addition to examining and analyzing the complaints of the expectant mother, it is most likely to diagnose symphysitis during pregnancy by ultrasound.
Ultrasound results differentiate pathology:
- The first degree of pathology is the divergence of the fissure of the pubic joint from five to nine millimeters. In the absence of other pathology, the obstetrician may allow the woman to give birth on her own.
- The second degree of manifestation of the disease - the gap has diverged by 10 - 20 mm. Mostly, a woman is given a referral for a caesarean section.
- The third degree of pathology – the distance increases by more than 20 mm. Observation in a hospital may be necessary. Childbirth only through caesarean section.
Symphysitis and natural childbirth
The question of choosing the route of delivery must be considered, taking into account the degree of stretching of the symphysis, the condition of the pregnant woman (the presence of gestosis and concomitant pathology), the size of the fetus and other factors influencing the decision.
Symphysitis and natural childbirth can cause excessive stretching of the joint of the pubic bones, even to the point of rupture. As a result, you may spend the next few weeks in bed. In addition, this condition requires special therapy against the background of the constant presence of pain.
Thus, happy motherhood for a month can turn into inpatient treatment and a minimum amount of time spent with the baby. At the moment, the child will also suffer, since breastfeeding, which cannot be carried out, is very important in the neonatal period.
Symphysitis and natural childbirth are still possible in some cases. This conclusion can only be made when examining a pregnant woman. The indicator for vaginal delivery is the expansion of the articulation to 1 centimeter. In addition, the woman’s pelvis should be quite wide, and the fetus should be of normal size (not large) and be in the head position.
Caesarean section and symphysitis
Before deciding on the choice of method of delivery, a thorough examination of the pregnant woman should be carried out and the presence of symphysitis must be taken into account. This pathology can become an obstacle to physiological childbirth.
In cases of severe symphysitis, the risk of rupture of the symphysis pubis, which connects the pubic bones, increases as the fetus passes through the birth canal.
Caesarean section and symphysitis go inseparably if the gap between the pubic bones increases by more than 1 centimeter. The remaining indicators can no longer be taken into account. However, if the joint has diverged less than 10 millimeters, but the fetus is large, or the woman has a narrow pelvis, or the fetus is in the pelvic position, or the condition of the pregnant woman does not allow her to give birth on her own, then a cesarean section must be performed.
The most important thing in resolving this issue is correct diagnosis and choice of delivery method. Examination of a pregnant woman is difficult due to the fact that it is undesirable for her to have an x-ray taken.
In this regard, the diagnosis is established based on the complaints of the pregnant woman. In addition, a gynecological examination and ultrasound examination are performed. In some cases, it is impossible to confirm symphysitis without computed tomography or magnetic resonance imaging.
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Treatment of symphysitis during pregnancy
The first thing to reassure pregnant women who have been diagnosed with symphysiopathy is that this pathology in no way affects the development of the fetus. Treatment of symphysitis during pregnancy is usually limited to this period. Because after obstetrics this pathology will “resolve” on its own. But we still have to live to see this moment. Almost all drugs aimed at suppressing foci of inflammation have pronounced toxicity, which adversely affects the development and future health of the fetus. Hence their limited use during pregnancy.
It is quite difficult to fight symphysiopathy. Therefore, most likely, it will not be possible to stop this problem during the gestation period. Based on the results of the ultrasound, the obstetrician observing the woman in labor will only make a decision: to perform a caesarean section or to allow the woman to have a natural birth. The only thing a doctor can do in this case is to reduce pain and discomfort using available methods.
- The doctor will prescribe a vitamin complex with a calcium dominant or a single calcium supplement to the woman in labor. But here it turns out to be a “double-edged sword”. After all, calcium in late pregnancy, on the contrary, is limited in the diet in order to avoid a number of other complications. Calcium strengthens bones, bringing a woman some relief, but at the same time, strengthening bone tissue can cause a difficult birth, because during labor they should be much more elastic. A high calcium content also makes the baby’s skull more durable and hard, which is undesirable when it passes through the birth canal.
- In this situation, a specialist can only offer the pregnant woman general recommendations that will help reduce pain and make the discomfort less noticeable. Basically, these are special therapeutic exercises and minor household tricks.
The main direction in the treatment of symphysitis is to stop the stretching process and reduce the severity of clinical manifestations.
Treatment of symphysitis during pregnancy includes limiting physical activity, but it is necessary to perform a special set of exercises. Thanks to it, the pelvic, lumbar and femoral muscles are strengthened and prevent further stretching of the symphysis pubis.
An indispensable condition for effective treatment is the use of a bandage that holds all pelvic structures in place. You should also not forget about vitamin complexes, in particular calcium and anti-inflammatory therapy.
Treatment of symphysitis during pregnancy should be carried out in specialized medical institutions, since pregnant women require special attention. It is necessary to ensure that they perform a special set of physical exercises correctly.
In addition, it is necessary to monitor the intake of calcium, since its use in the last stages can lead to undesirable consequences during labor. This can strengthen the fetal skull bones, making it difficult to pass through the birth canal.
Exercises for symphysitis during pregnancy
In order to somehow make pregnancy more comfortable for a woman with symphysiopathy, doctors suggest that she do special exercises for symphysiitis during pregnancy several times daily, which will strengthen the muscles of the pelvis, sacrum, lower back and hips.
- You need to very carefully lie on the mat with your back down. In this case, the legs are bent at the knees, and the feet are moved so that they touch the buttocks (if you can’t put them so close, don’t be upset, put them as it turned out). We begin to move our knees in different directions synchronously, very slowly, without jerking. Lie in this position for a while, and then return your knees to their place, connecting them to each other. This exercise must be done at least six times.
- The starting position is similar to the previous one, but the feet are positioned so that the calf muscles are perpendicular to the floor. Very smoothly and slowly we begin to lift our buttocks up. At the same time, there is no need to be a hero. Nobody demands a perfect bridge from a pregnant woman; it is enough to lift the buttocks up a few centimeters. We carefully begin to lower ourselves, but at the moment when the tailbone is already touching the surface, we need to pull back a little, holding the touch as long as possible. Do six such repetitions.
- And now the “cat” exercise, beloved by many women. To do this, the expectant mother needs to get on all fours, relaxing her back as much as possible. The spine, head and neck should form one line. We bend the spine upward as smoothly as possible. At the same time, the head and tailbone go down, and the muscles of the thighs and groin tense. Slowly return to the starting point. Make two or three such waves.
This complex should be done by a pregnant woman several times throughout the day, especially when pain increases.
Prevention of symphysitis during pregnancy
Symphysitis does not threaten the life of a pregnant woman, but in combination with other factors, for example, a large fetus, its breech presentation or a woman’s narrow pelvis, it can lead to a lot of problems during labor.
Prevention of symphysitis during pregnancy consists of taking vitamin complexes, regularly visiting the pool and playing sports. Of course, heavy physical activity during pregnancy is contraindicated, but specially designed exercises will not only help prevent the development of symphysitis, but will also help during labor.
Prevention of symphysitis during pregnancy also includes frequent changes of body position, especially sitting in front of the computer, crossing your legs and bending at the back. This body position leads to stagnation of blood in the lower extremities and pelvis.
In addition, it is necessary to control the calcium level in the body. By enriching your diet with foods with a large amount of this microelement, you can reduce the likelihood of developing symphysitis.
However, you should be extremely careful, since excess amounts of calcium in the last stages can provoke various types of problems during childbirth. Thus, the bones of the fetal skull become denser, which complicates the baby’s movement through the birth canal.
To alleviate the physical condition of the expectant mother, prevention of symphysitis during pregnancy comes down to following a few simple recommendations.
- During the third trimester of pregnancy, a woman must wear a special support bandage.
- It is necessary to somewhat limit her physical activity.
- The daily set of exercises given above.
- In severe cases, you can call for help:
- Special walkers.
- Cane.
- Wheelchair.
- If you need to lie down, you should first carefully sit down on the bed. Then lay your upper torso sideways on the surface, then raise both legs pressed to each other at the same time and lay them on the bed.
- If you want to stand up, you should use the reverse sequence. By adhering to these simple rules, you can significantly reduce discomfort and avoid increased pain, which invariably occurs during a sharp rise.
- If there is a need to roll over from one side to the other, your legs must also be kept together.
- Minimize the use of stairs whenever possible.
- You should avoid both very soft and too hard seats.
- When moving, steps should be small and movements should be smooth.
- Need to get into the car? First, sit your butt down, and then simultaneously bring your legs pressed together into the salon.
- Swimming in warm water also has a positive effect.
- During sleep, to relieve tension, you should place a small pillow between your thighs.
- Asymmetrical body positions should be avoided:
- Don't cross one leg over the other.
- There is no need to carry the entire load on one leg.
- Do not lean on one arm or side.
- Avoid prolonged sitting, and your knees should not be higher than your pelvis.
- You should not walk or stand for a long time. It is necessary to alternate walking with rest.
- It is necessary to minimize fetal pressure on the lumbopelvic region and pubis:
- You can place a bolster under your buttocks, lifting your pelvis.
- Place your feet on a hill.
- It is necessary to carefully monitor weight gain, avoiding excesses.
By following these simple rules, the condition should stabilize and the pain should not be so intense. If relief does not occur, you must tell your doctor about this during a scheduled appointment.
Prognosis of symphysitis during pregnancy
This pathology can contribute to the development of serious complications during childbirth. Thus, ruptures of the symphysis pubis are possible during labor.
The prognosis of symphysitis during pregnancy depends on the severity of the pathology. If the expansion of this connection is no more than 1 centimeter, then symphysitis does not pose a threat to the pregnant woman and the fetus. However, if the distance between the pubic bones exceeds 1 centimeter, then the issue of a cesarean section is decided.
The prognosis for symphysitis during pregnancy is quite favorable, provided that all rules for preventing further bone separation are followed. To do this, you need to perform a certain set of physical exercises, use a bandage that holds all pelvic structures in a normal position, and adhere to a proper diet.
You should not treat symphysitis on your own during pregnancy, since only a specialist will be able to select the correct therapeutic methods and prescribe effective treatment.
Symphysitis is an inflammation of the symphysis, that is, the transitional connection between the bones of the skeleton. Symphysitis during pregnancy is not so rare.
The growing fetus puts pressure on the bone joint. And, if a slight discrepancy of the bones is the norm, then excessive softening of the symphysis is considered a disease and is a direct indication for a cesarean section.
What is symphysitis and the reasons for its appearance?
During pregnancy, the fetus is constantly developing and growing. At the same time, the uterus increases in size. This leads to increased pressure on the pelvic bones and tension in the pubic area.
In addition to this load on the pelvic bones, the body of a pregnant woman is influenced by various hormones.
The hormone relaxin is supplied in large quantities, which performs many important functions. For example, the growth and expansion of the uterus, expansion of the pelvic bones and weakening of ligaments, opening of the cervix during childbirth, etc.
Under the influence of the above factors, softening and divergence of the pubic symphysis occurs. The following factors may additionally influence:
- large fruit;
- structure of the pelvis (narrow lumen of the pelvic bones);
- insufficient intake of vitamins and minerals.
The cause of symphysitis during pregnancy is difficult to clearly identify. All of the above factors can lead to the development of this pathology.
Doctors also believe that hereditary factors and problems with the musculoskeletal system that appeared before pregnancy may have an impact.
Symphysitis during pregnancy can lead to negative consequences. But the prognosis is usually favorable.
Symptoms
Symptoms of symphysitis during pregnancy most often appear towards the end of the second and beginning of the third trimester. Inflammation of the symphysis is characterized by the following symptoms:
- Swelling in the area of the pubic joint. At first it is insignificant, but as the disease progresses, the swelling becomes stronger;
- Pain in the pelvic and pubic area, as well as in the groin, tailbone and hips. Painful sensations change the gait of a pregnant woman, she walks waddling from side to side;
- Pain and clicking sensations when palpating the pubic area;
- Sharp pain when changing body position, when climbing stairs;
- Constant feeling of heaviness in the pelvic area;
- Inability to raise straight legs while lying down due to severe pain;
- As the disease progresses, painful sensations appear at rest. It is difficult for a pregnant woman to find a comfortable position that reduces pain.
Treatment of symphysitis
How to determine symphysitis during pregnancy? This question worries women who have certain symptoms of the disease.
Before making a diagnosis, it is necessary to carry out additional diagnostics (read also the article What tests are taken during pregnancy?>>>).
Symptoms of the disease are usually pronounced and there are no problems with making a diagnosis. But an ultrasound scan for symphysitis during pregnancy will help identify not only the disease itself, but also its stage.
There are three stages in total:
- the first, in which the expansion is 5-9 mm;
- the second, with a distance from 10 to 20 mm;
- third, the distance between the bones is more than 20 mm.
When treating symphysitis during pregnancy, calcium supplements are prescribed. But only if indicated, since in the last months of pregnancy calcium can do more harm than good.
In the third stage of the disease, bed rest may be prescribed.
By the way! Currently, special corsets have appeared on sale that are designed to hold the pelvic bones. When using such a corset, bed rest is not so strict.
If the pain is severe, the pregnant woman may be hospitalized. At the hospital, she will be prescribed physical therapy to help relieve the pain.
Why is symphysitis dangerous during pregnancy?
Fortunately, the disease does not affect the baby’s health in any way.
But this disease cannot be called harmless. Inflammation of the pubic area subsequently leads to its loosening and weakening + pain brings a lot of discomfort to the expectant mother.
In addition to the pain symptom, a woman may be prohibited from giving birth naturally.
Attention! Some pregnant women are very worried about this, because they wanted to give birth on their own. But with such a diagnosis, it is important to take into account the opinion of doctors.
Prevention of symphysitis
- Taking additional vitamins should only be based on a clinical blood test;
- It happens that the calcium-phosphorus metabolism in the body is disrupted, which prevents the body from absorbing calcium in the required quantities from food;
- In this case, you can visit a homeopathic doctor who will help correct this disorder. Homeopathy is safe during pregnancy.
I'll tell you my personal experience.
Starting from my second pregnancy, around the 20th week of pregnancy, my pubis began to hurt terribly.
After every walk or exercise around the house, I wanted to lie down and lie down. Towards the end of the pregnancy, it was painful to even turn over from one side to the other while sleeping.
All these are signs of symphysitis.
It is important not to panic if the doctor makes such a diagnosis, but be sure to ask the diagnostician at the next ultrasound to measure the distance of the symphysis in order to understand what the discrepancy is.
Despite the severe pain, my discrepancy was small. those. your sensations are not a marker of the severity of the condition.
According to a blood test, my calcium was normal.
- During pregnancy, in addition to observation at the antenatal clinic, I was also observed by a private midwife, who was very involved in my nutrition and we tried to correct the pain through nutrition;
- Every week I was told to cook jellied meat and consume this natural gelatin so that the ligaments would be stronger. That's what I did. The condition is not much, but it has improved;
- In addition, I always wore a brace on long walks to reduce the load on the pubic bones.
I gave birth myself, no one even talked about a caesarean section.
During my third pregnancy, the condition was similar, I was already mentally prepared for it, so I treated it as an inevitable situation - apparently my body is simply prone to such a course of pregnancy.
Particular attention should be paid to preparing for childbirth: practice proper breathing, do not push during labor ahead of time, push correctly so that the load on the symphysis is adequate.
I talk about these points in the online course Easy Childbirth: how to give birth without ruptures and protect the baby from birth injuries >>>
It is also very important to take care of yourself after childbirth:
- The hormone relaxin leaves the body gradually, so for the first 10 days, try to spend the maximum amount of time on bed rest so that weak ligaments are not damaged;
- Slowly increase the load. If you feel that while walking or carrying a child in your arms, unpleasant sensations appear in the pubic area - buy a bandage or tie a thick scarf under your stomach;
- Also, be sure to go to an osteopath during pregnancy and immediately arrange an appointment with him after 40 days after birth. He will fix all your muscles and ligaments so that your body returns to normal faster.
What else can help you to slow down the progression of symphysitis:
- Change of body position. To prevent blood from stagnating in the pelvis, you should not sit in front of the computer or TV for a long time. From time to time you need to get up, you can do a couple of simple exercises;
- In the third trimester, it is necessary to wear a special bandage that will reduce the load on the pelvic bones;
- If possible, climb stairs less often;
- All movements should be smooth, both when walking and when changing body position;
- Watch your diet; your diet should contain enough vitamins and nutrients. But you should also avoid excessive weight gain;
- While resting, elevate your legs and place a small pillow under your buttocks so that your pelvis is slightly elevated.
As you can see, the disease brings a lot of inconvenience during pregnancy, but you can survive everything and give birth yourself.
Therefore, a positive attitude is our everything!
Ask your questions in the comments, I will help as best I can.