[Pregnancy-associated symphysis damage from the orthopedic viewpoint--studies of changes of the pubic symphysis in pregnancy, labor and post partum].

AIM: Is the sonographic measurement of the symphysis pubis enough to enable a prognosis of the occurrence of symphyseal pain during pregnancy and birth?

METHOD: First of all, a simplified definition of symphyseal pain was categorized in order to make the classification more easy. The symphyseal widths of 171 pregnant women were measured during pregnancy and after birth. Our control group consisted of 25 non-pregnant women. 15 of the 171 patients suffered from symphyseal pain; however, 156 of the 171 did not. Additionally, we measured the intrapartal symphyseal width in 11 of the women.

RESULTS

The average symphyseal width of non-pregnant women was 4.07 mm (s = 0.79; n = 25). Pre- and postpartally we measured 6.32 mm (s = 1.71; variation of 3 to 16 mm) in pregnant asymptomatic women. A significant increase in width was recorded in the 15 women with pain in the symphysis: the symphyseal width was 10.62 mm (s = 2.37; Variation from 6.7 to 15.25 mm). Intrapartally the symphyseal width varied between 5.8 and 1.2 mm.

CONCLUSION

Ultrasound measurement of the symphyseal width shows around 4 mm in non-pregnant women. Asymptomatic pregnant women have an average width of 6.3 mm. The majority of pregnant women with 9.5 mm or more have symphyseal pain. If that is the case then conservative treatment is usually sufficient to cure this complaint.