Norvilaite K, Kezeviciute M, Ramasauskaite D, Arlauskiene A, Bartkeviciene D, Uvarovas V. Postpartum pubic symphysis diastasis-conservative and surgical treatment methods, incidence of complications: Two case reports and a review of the literature. World J Clin Cases 2020; 8(1): 110-119 [PMID: 31970176 DOI: 10.12998/wjcc.v8.i1.110]
Corresponding Author of This Article
Kristina Norvilaite, MD, Doctor, Lecturer, Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, No. 2 Santariskiu street, Vilnius LT-08661, Lithuania. kristina.norvilaite@gmail.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Jan 6, 2020; 8(1): 110-119 Published online Jan 6, 2020. doi: 10.12998/wjcc.v8.i1.110
Postpartum pubic symphysis diastasis-conservative and surgical treatment methods, incidence of complications: Two case reports and a review of the literature
Kristina Norvilaite, Diana Ramasauskaite, Audrone Arlauskiene, Daiva Bartkeviciene, Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-08661, Lithuania
Monika Kezeviciute, Vilnius University, Institute of Clinical Medicine, Faculty of Medicine, Vilnius LT-08661, Lithuania
Valentinas Uvarovas, Department of Orthopedics and Traumatology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius LT-08661, Lithuania
Author contributions: Norvilaite K, Kezeviciute M, Ramasauskaite D, Arlauskiene A, Bartkeviciene D, Uvarovas V analyzed the clinical cases, reviewed the literature and contributed to manuscript drafting, all authors approved the final version to be submitted.
Informed consent statement: Informed written consent was obtained from the patients for publication of this report and accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Kristina Norvilaite, MD, Doctor, Lecturer, Clinic of Obstetrics and Gynaecology, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, No. 2 Santariskiu street, Vilnius LT-08661, Lithuania. kristina.norvilaite@gmail.com
Received: September 25, 2019 Peer-review started: September 25, 2019 First decision: November 11, 2019 Revised: November 18, 2019 Accepted: November 27, 2019 Article in press: November 27, 2019 Published online: January 6, 2020 Processing time: 103 Days and 16.1 Hours
Core Tip
Core tip: Widening of the pubic joint of more than 10 mm is diagnostic and defined as pubic symphysis diastasis and is considered a complication of vaginal childbirth or pregnancy. As it is a rare pathology and no gold standard treatment is defined, we present two cases with severe pain in the pubic region after labour, accompanied by complicated locomotion. Pubic symphysis diastasis was confirmed radiologically in both cases and conservative treatment was recommended. No benefit following conservative treatment was observed, thus surgical treatment was selected and internal pubic synthesis was performed. These cases show that standardisation of conservative and surgical treatment or studies of possible complications have not been defined; therefore, postoperative infections are likely to complicate surgical treatment. Overall, our findings demonstrate the significance of an accurate choice between conservative and surgical treatment due to possible complications after surgical intervention such as infection, loose screws, fistula and repeated surgical management.
