Symphysitis during pregnancy: treatment and prevention are necessary. Symphysitis - an unpleasant surprise of pregnancy

There are many changes in the body of a pregnant woman. All of them are aimed at making the birth of a healthy child possible, as well as at making this process as easy as possible.

Changes affect literally the entire body, including the musculoskeletal system. In particular, under the influence of the hormone relaxin, the joints in the pelvic bones soften. This increases their mobility, and it is easier for the fetus to pass through the birth canal during childbirth.

But not always conceived by nature goes according to the scenario. Various failures often occur, as a result of which pathologies arise that leave their mark on the course of pregnancy and the course of childbirth. One of these pathologies is symphysitis.

What is symphysis and symphysite?

The word "symphysis" in medicine means the pubic articulation of the bones, what we used to call the pubis. During pregnancy, this joint naturally stretches, gaining some mobility. This, as already mentioned above, is a normal process necessary for the successful completion of childbirth.

However, for one reason or another, this process can go wrong. As a result, the joints soften too much, become hypermobile and strongly stretched, which leads to swelling of the pubis, pain, and discomfort. It is this condition that is called symphysitis.

Causes of symphysitis

Unfortunately, doctors have not yet come to a consensus about what exactly leads to the development of symphysitis. There are several opinions on this matter. In particular, many doctors are confident that the development of this pathology is associated with a lack of calcium in the mother's body. In addition, symphysitis is associated with hormonal disorders, namely with an excess of the hormone relaxin. Since during pregnancy the hormonal background of a woman is not stable, from time to time violations occur in the well-established mechanism.

There are also theories linking this disease with hereditary characteristics and various problems of the musculoskeletal system, which could have arisen even before the onset of pregnancy. Not the last place is given in the list of possible causes of symphysitis and directly to the course of pregnancy. There is an opinion that rapid weight gain, physical activity, non-compliance with the regime and an inappropriate diet can affect the hormonal background of a woman, and, consequently, cause symphysitis.

Symptoms and diagnosis of symphysitis

Since the softening of the joints normally begins closer to childbirth, then its symptoms, as a rule, begin to disturb women in the third trimester of pregnancy. However, it is not uncommon for them to visit the patient already in the middle of the 2nd trimester.

How to define symphysitis? With due care, this can be done already at an early stage, when the changes are not yet too strong. First of all, a woman begins to be disturbed by pain in the pubic area while walking, climbing stairs. During this period, it is easy not to attach importance to painful sensations, writing them off as natural changes. Then the disease continues to develop.

As it develops, the pain intensifies and disturbs the woman already in a calm, and sometimes in a lying position. When turning, getting up from a chair or bed, lifting the legs, the pain becomes even stronger.

Pubic edema is also a characteristic symptom of symphysitis. Together, this leads to a strong change in gait. The steps become short, heavy, the woman walks slightly waddle. It is this gait that is colloquially called duck.

If a woman observes all or part of the signs of symphysitis, she must immediately inform her gynecologist about this. After all, this disease is not only painful, it can affect the course of childbirth.

Childbirth complicated by symphysitis

Due to too much stretching of the joints during childbirth, they can tear. And this means several weeks of bed rest, complex treatment, pain and much more, which is poorly combined with happy motherhood. Instead of taking care of her newborn child, the woman will be forced to endure considerable suffering and look for an assistant during the treatment. But not everyone has the opportunity to find a nanny. Yes, and I want to take on these pleasant chores myself. And for one thing, and establish contact with your baby, because this is also very important.

But, despite such serious risks, the presence of symphysitis does not at all put an end to natural childbirth. If the pubic articulation has diverged by no more than 10 mm, the fetus is not large and is in the head position, and the woman's pelvis is wide enough. If one or more of these conditions is violated, then doctors will recommend a caesarean section.

Diagnosis of symphysitis during pregnancy is difficult because it is extremely undesirable for women in position to take an x-ray. For this reason, the initial diagnosis is based on the woman's descriptions of the nature and severity of the pain. Often the doctor conducts a gynecological examination, and an ultrasound is prescribed for clarification. Computed tomography or magnetic resonance imaging can also help to make a diagnosis.

Treatment and prevention

Unfortunately, it is impossible to cure symphysitis. It just goes away after childbirth, when the hormonal levels even out. Relaxin ceases to affect the bones and joints, and they return to normal. Therefore, the treatment of synphysitis during pregnancy comes down to alleviating the condition of the woman and choosing the right birth strategy.

First, it is necessary wear a special bandage on the hips which resembles a tight skirt. It will support the pelvis and hips, preventing further stretching of the joints. This helps relieve puffiness.

Secondly, women with symphysitis do not walk, stand or sit in one place for more than 1 hour . Legs should be kept in a symmetrical position.

Also, include in your diet more foods rich in calcium . For example, milk, cottage cheese, yogurt, cheese, other dairy products, herbs, nuts, fish. It is very important to normalize digestion, as this will increase the absorption of calcium. In addition, excessive weight gain should be avoided, as this increases the load on the softened joint.

By the way, it is important to remember that calcium is well absorbed only if the body has enough vitamin D. The nuance is that this vitamin is not absorbed from food by our body, but is synthesized under the influence of sunlight. So pregnant women with symphysitis need to be outdoors more often. And in winter, it makes sense to take additional vitamin D. It can be taken together with calcium preparations.

In severe cases, hospitalization may be required. As part of the course, a woman is given physiotherapy, anti-inflammatory drugs, and anesthesia. For special indications, epidural analgesia may be performed. But hormonal therapy for symphysitis, as a rule, is not prescribed.

Prevention of symphysitis is a difficult matter, since the causes of the disease have not been reliably identified. However, it is believed that it is still possible to reduce the risk of the disease. To do this, it is recommended to reduce physical activity, replace them with special gymnastics and exercises that your doctor will recommend to you. It is not worth picking up a course of exercises on your own, since each woman may also have individual contraindications to certain actions.

No less important for prevention is a diet that includes, as in treatment, a large amount of calcium. Taking a multivitamin containing calcium and vitamin D will also not be superfluous. This is especially true in winter, when even frequent walks cannot provide enough vitamin D, since the sun sets early and rises late.

Unfortunately, symphysitis is a fairly common disease. According to statistics, to one degree or another, up to 50% of pregnant women face it. It is noticed that if in the first pregnancy there was a disease, then in the second and subsequent, most likely, the woman will face the same problem.

Fortunately, symphysitis does not affect the child. Yes, and for the mother, the risk is minimal: doctors carefully monitor the condition of the pregnant woman, and in case of danger, she simply will not be allowed to give birth herself, but will perform a planned caesarean section. And after childbirth, the hormonal background normalizes, and all bone joints return to their normal state. And along with this, soreness and swelling will disappear.

Answers

Many women are frightened by stories that during pregnancy and childbirth, a rupture of the pelvic bones can occur, which entails serious treatment and long-term rehabilitation. And they associate any discomfort in the womb area with such changes. Significant discrepancy of the pelvic bones (symphysiopathy) with a vivid clinical picture occurs in no more than 3-5% of pregnant women. But inflammation and discomfort are much more common. What are the symptoms of symphysitis during pregnancy and when can it pose a threat?

According to the international classification (ICD-10), all such pathology is included in the heading O26.7 "Subluxation of the pubic joint during pregnancy and childbirth." In practice, many terms are used:

• symphysiopathy;
• symphysiolysis;
• symphysite;
• dysfunction of the pubic joint.

In principle, these are concepts that describe the stages of one process of changing the pubic joint during gestation.

Why does

The pelvis is a kind of ring of several bones (iliac, ischial, pubic and sacrum). Semi-joints are formed on the borders of each, which includes layers of cartilage tissue, but are characterized by low mobility. Under the action of the gestagenic background, the properties of the tissues of the semi-joints change already in the early stages. This leads to their softening, divergence, increased mobility and the likelihood of inflammation. These processes are necessary for some increase in the size of the pelvis, which is later important in the process of childbirth.

The pubic joint is located in the suprapubic region and has some features that contribute to the most frequent trauma and complications in this area. Namely:

• it accounts for the maximum load during gestation;
• its surface is small, which increases the pressure per unit area.

Under the influence of provoking factors, there is an increase in the production of a special protein - relaxin. It acts on cartilage fibers, reducing their strength and stability of joints. Similar processes occur not only in the womb, but also in other joints and ligaments. But here the picture is most vivid due to the additional influence of the uterus and fetus. These are the main causes of symphysitis in pregnant women.

What provokes symphysitis during pregnancy

Symphysitis during pregnancy is quite common. Predisposing factors for its occurrence are the following factors.

• Heredity. The pathology of the pubic joint is more common in people with "English roots", as well as in girls whose grandmothers or mothers had similar problems. Most likely, this is due to the pathology of the connective tissue, which forms cartilage layers.
• Pelvic injury. Previous operations, fractures violate the anatomy and predispose to divergence and inflammation of the pubic joint. Including if symphysitis or symphysiolysis were in previous births.
• Hormonal disorders. Early periods, long-term use of hormonal contraceptives, taking corticosteroid hormones affect bone structure.
• Large fruit. The larger the baby, the greater the load on the pubic joint. Therefore, most often its inflammation or divergence occurs during repeated births, when the children are larger.
• Violation of calcium metabolism. Diseases of the thyroid and parathyroid glands, calcium deficiency in case of its insufficient intake causes "washout" of its bones, which reduces the strength of all joints. Signs of symphysitis in this case may appear as early as the 1st trimester.
• Kidney disease. Pathology is accompanied by a violation of mineral metabolism and increased excretion of nutrients. As a result, the body is forced to "borrow" calcium, sodium and other elements from the bones.

When to Suspect a Problem

Most often, signs of symphysitis during pregnancy appear at the end of the 2nd trimester due to the increasing load on this area. But even a significant separation of the pubic bones up to a certain point can be almost asymptomatic. It is believed that the entire clinical picture manifests itself when inflammation joins.

• Pain in the region of the womb. It can be sharp, give to the leg, groin, sacrum. Sometimes this causes a change in gait, she becomes "duck". But more often these are aching unpleasant pains that increase when walking, especially with a sharp movement, and significantly decrease in a calm state. Less commonly, women note discomfort during intimate relationships, during urination and defecation. When pressing on the pubic joint, its soreness is also noted.
• Signs of inflammation. A slight swelling, redness may appear over the womb area.
• Other discomfort. Sometimes expectant mothers note a "click" in the area of ​​​​the pubic bones, especially when walking and turning the body.

Diagnostics

The diagnosis begins with a general examination and clarification of the woman's complaints. Sometimes with symphysitis with a large discrepancy in the womb region, retraction is determined. Ultrasound is the safest diagnostic method. In this case, it is even possible to identify the degree of divergence of the pubic bones:

• 1 degree - up to 1 cm;
• 2 degree - up to 2 cm;
• 3 degree - more than 2 cm.

The norm for the divergence of the pelvic bones during pregnancy is a distance of 0.5 cm.
Routine blood and urine tests do not change. Radiography, CT and MRI are practically not used, since the risk from the procedure is unjustified. They are carried out, if necessary, after childbirth.

Symphysitis may have a blurred clinical picture. In this case, it is necessary to carry out differential diagnosis with diseases similar in manifestations. The main differences are described in the table.

Table - With what it is necessary to differentiate symphysitis

Only a specialist knows how to identify symphysitis and distinguish it from other diseases during pregnancy. Therefore, if you have complaints, you need to seek medical help.

What is the dangerous condition

Thinking about how dangerous symphysitis is during pregnancy, it must be emphasized that all women with a similar problem have a chance of a serious divergence of the pubic bones during childbirth. This may be accompanied by a rupture of the bladder and other organs and structures of the small pelvis.

There are no consequences for the fetus, with the exception of the possible negative effect of drugs that a woman can use to relieve pain.

How to treat

Experiencing discomfort and even more difficulty walking, every woman thinks about how to alleviate symphysitis without endangering the baby during pregnancy. It is important to understand that there will be no radical treatment until the moment of delivery. All recommendations are aimed at reducing the severity of pressure on the area of ​​the womb, reducing inflammation and pain.

• Wearing a bandage. With a slight discrepancy, on the recommendation of a doctor, you can use the usual belt for pregnant women. In more severe cases of symphysitis, special fixing bandages are needed that pass through both trochanters of the femur.
• Painkillers. It is allowed to use "Diclofenac" ("Ortofen"), "Fastum-gel", "Apizartron" - only in the form of ointments topically, and with caution in the 3rd trimester. For more severe attacks, rectal suppositories with papaverine and tablets can be used. The names of permitted and prohibited painkillers for symphysitis in pregnant women are indicated in the table below.
• Physiotherapy. To relieve pain, cold compresses on the womb area, acupuncture, UVI help.

Table - How to relieve pain with symphysis

Prevention of pathology

• Exercise "Cat". It is necessary to become with emphasis on the knees and palms. Then arch and lower your back, rhythmically moving your head in the opposite direction. The exercise can be performed at any time.
• Exercise "Frog". In the supine position, the legs should be bent at the knees and brought to the stomach. Next, you need to slowly spread to the sides and bring your knees.

It is equally important to monitor body weight so as not to create an additional load on the pubic joint. It is useful to take vitamin complexes with calcium, magnesium, and also eat a balanced diet.

Forecast

In most cases, symphysitis does not affect gestation, but disrupts the activity of a woman, bringing pain. To prevent more serious complications, it is important to decide on the method of delivery at the end of pregnancy. For this, clinical data and research results are compared. And even a divergence of the bosom of 1 cm is not always a contraindication to natural childbirth, especially with a medium-sized fetus. If there is even the slightest suspicion of complications, a caesarean section is performed.

Finally, the question of whether it will be possible to give birth with symphysitis during pregnancy is decided closer to the end of gestation after examination and examination by the necessary specialists. Reviews of women and doctors prove that the right approach helps to avoid more serious consequences.

Symphysitis is a serious pathology that is characteristic of the gestation period and after childbirth. Timely identified deviations and the right tactics will help to avoid a serious divergence of the womb. Treatment of symphysitis during pregnancy consists of conservative measures - anesthetic ointments and tablets, physiotherapy. Operations to restore the integrity of the pubic joint are performed only after childbirth.

Pregnancy is a happy period in a woman's life. But sometimes it happens that it is overshadowed by concomitant diseases that complicate the birth process. Sudden hormonal changes and an increased load on internal organs are natural factors that affect the condition of the expectant mother. One of the frequent disorders encountered at this time is symphysitis.

What is symphysis

During childbirth, the fetus passes through the woman's hip joint, which imitates a ring. In front, it consists of two bones that form the pubis (or pubic symphysis). During pregnancy, the body of the expectant mother produces the hormone relaxin, which is responsible for softening the joints of the joints. This is a physiological necessity and is necessary for the safe passage of the fetus through the birth canal.

Under the influence of some factors, a failure may occur: the joint softens too much. As a result, it stretches excessively and becomes more mobile than is acceptable. In this case, pregnancy is accompanied by pain in the pubic area, which can turn into swelling in this area. This phenomenon is called symphysitis.

According to statistics, symphysitis occurs in every second expectant mother. This condition does not pose any threat to the development of the fetus, but it causes a lot of discomfort in the process of bearing a child and can be dangerous complications during childbirth.

Despite complications, with diagnosed symphysitis, natural childbirth is possible - it depends on the degree of divergence of the pubic bones.

Diagnosis of symphysitis and the causes of its occurrence

The exact causes of the disease have not been established by medicine. Among the theories explaining the excessive softening of the symphysis during pregnancy, there are 2 main ones:

• lack of calcium, which is the main component of building bone joints (its lack makes the joint more mobile, as a result of which, due to the increased load on the hip joint, the bones diverge too widely);
• excessive production of relaxin.

Diagnosis of symphysitis is difficult because X-ray, which gives the most accurate picture, is contraindicated in the perinatal period. As a rule, doctors primarily rely on symptomatic indicators, and then prescribe an additional examination.

How to determine symphysitis during pregnancy: dangerous symptoms

More often, symphysitis occurs in the third trimester, but already from the middle of pregnancy, it is important for the expectant mother to observe her feelings in the pubic area. If one of the following signs of the disease appears, you should consult an obstetrician-gynecologist:

• difficulty climbing stairs
• feeling as if something clicks in the pelvis while walking;
• pain in the pubic area, which increases if you try to take your leg to the side;
• the appearance of lameness and waddle gait (although this may be due to a large load on the lumbar region);
• pain in the hip joint and lumbar (more often they occur at night and are accompanied by the inability to move freely);
• inability to raise legs up from a lying state;
• swelling in the pubic area, especially if it is single.

If symphysitis is suspected, the doctor determines the degree of risk of its occurrence based on the anamnesis (surgery, previous births, hip joint injuries), lifestyle, and dietary habits.

To confirm the diagnosis, an ultrasound examination is prescribed, which shows the presence of bone divergence and its degree. On the recommendation of a gynecologist, it is possible to consult a physiotherapist and an orthopedist.

Degrees of the disease

Depending on the degree of divergence of the pubic bones, various complications are possible. The most severe of these may be a rupture of the articulation. This is a very severe injury that requires long-term treatment, including bed rest.

Depending on the width of the discrepancy, three degrees of symphysitis are distinguished:

• 0.5–0.9 centimeters (first degree);
• 1–1.9 centimeters (second degree);
• more than 2 centimeters (third degree).

With diagnosed symphysitis of the first degree, natural childbirth is assumed (subject to all medical recommendations and the absence of disease progression). But even in this case, there is a minimal risk of rupture of the pubic joint. The second and third degree are an indication for a caesarean section.

Symphysitis treatment

All treatment of symphysitis during pregnancy is aimed at alleviating the physical condition of the woman and preventing the disease from progressing. If the divergence of the articulation arose while waiting for the child, it goes away on its own after childbirth and the restoration of the hormonal background.

Wearing a bandage

To relieve pain, the expectant mother is recommended to wear a special bandage, which helps relieve swelling and, due to additional support for the lower abdomen, prevents the discrepancy from increasing in size.

Trying on a bandage before buying should take place in the prone position. When lifting, it is estimated how tightly it supports the hip joint.

Supplementation with calcium and vitamins as an early aid

With symphysitis, the doctor may prescribe an additional intake of calcium. However, this decision should be balanced, since an excess of the mineral in the later stages can reduce the mobility of the baby's skull bones and make it difficult for the head to pass through the birth canal. In addition to calcium, special vitamin and mineral complexes for pregnant women are most often recommended.

Vitamin-mineral complexes for expectant mothers, which can be prescribed by a doctor for diagnosed symphysitis - photo gallery

Vitrum Calcium is prescribed if it is necessary to replenish calcium and vitamin D3 Calcium is often prescribed in conjunction with vitamin D, which allows the mineral to be absorbed in the maximum amount
Elevit Pronatal Complex contains 3600 IU of retinol palmitate
The Alphabet Mom's Health tablet contains 40% of the daily requirement of beta-carotene Vitrum Prenatal improves a woman's well-being and improves immunity

Pain Reduction: Exercise, Physical Therapy, Home Remedies

To prepare for natural childbirth and reduce the pain caused by symphysitis, gymnastics that strengthens the joints helps. A set of exercises must be approved by a doctor. A great addition to the treatment of symphysitis will be special courses for pregnant women (for example, yoga).

As a physiotherapeutic effect, magnetotherapy is prescribed on the area of ​​​​the pubic symphysis (this is the effect of a magnetic field with a low frequency). Of the folk remedies that help with symphysitis, one can distinguish nutrition with the obligatory use of foods high in calcium (hard cheese, sardine, sesame, almonds, milk, white cabbage).

The occurrence of symphysitis is possible during childbirth. This happens if the fetus is large or with a narrow hip joint. Severe postpartum bone dehiscence requires complex treatment that includes medications (including calcium and anti-inflammatory drugs).

Prevention of symphysitis

The best way to prevent the onset of a disease is to prevent it. Pregnancy planning makes it possible to be examined in advance and identify risk factors for the occurrence of symphysitis.

Registration for pregnancy for up to 12 weeks and regular visits to the gynecologist will allow you to notice the disease at an early stage and prevent its development. Proper nutrition, which excludes a large amount of carbohydrates, but implies the use of food rich in proteins and calcium, will help the body to function normally. And the prophylactic wearing of a bandage, starting from the middle of the second trimester, even in the absence of symphysitis, will ease the load on the lower back and hip joint.

A set of exercises and yoga for pregnant women will help strengthen the muscles of the buttocks, hips, back, due to which the load on the joints will decrease, and childbirth will be less painful.

Divergence of the pubic joint - video

Symphysitis manifests itself most often in the third trimester of pregnancy, in the second trimester this pathology is very rare

Typical symptoms of symphysitis:

• swelling in the pubic area (pubic joint)
• the so-called "duck" gait of a pregnant woman
• sharp pain when pressing on the bones of the pubis, audible clicks during this action
• pain when changing body position
• walking is characterized by small steps
• pain and a feeling of heaviness when climbing stairs
• pain and discomfort in the pelvis, groin, coccyx, thigh, pubis
• lying down there is no way to raise straightened legs up

Any symptoms you notice should be reported to your doctor.

signs

This pathology tends to develop, pain sensations will become even more expressive. Not only the movement will cause suffering, but in the prone position a woman may feel pain.

Similar signs may indicate other changes in the mother's body. It would be wrong to diagnose this disease yourself, but if there are suspicions, immediately go to the doctor. Otherwise, the disease will progress. Since X-rays are not taken during pregnancy, the doctor will make a diagnosis based on the woman's complaints and examination.

The reasons

We repeat: the true causes of symphysitis have not yet been clarified.

And yet today, doctors are inclined to believe that the lack of calcium is “guilty” of it.

Of course, hormonal changes during pregnancy cannot be ignored. The hormone relaxin allows the bone tissue to soften, which is why the symphysis also stretches. And although this process is natural, this is how nature prepares the mother's body for delivery, sometimes such complications arise.

So, there are 4 main causes of symphysitis:

• lack of calcium
• hormonal changes
• hereditary factor
• problems with the musculoskeletal system before pregnancy

What is dangerous (and is it dangerous?) During pregnancy?

For Mom
This disease cannot be called harmless. It causes considerable suffering to a woman and affects how exactly she will give birth.

The course of pregnancy, the size of the child, the number of previous births can affect the fact that a woman will give birth by caesarean section. In the maternity hospital, the doctor should be aware of this diagnosis, because during natural childbirth with symphysitis, the risk of rupture of the pelvic joints is high.

The latter will entail a long recovery, bed rest for at least 2 weeks, special exercises, consultations with many specialists. Having a newborn baby in her arms, a woman will not be able to painlessly go through this path, so it’s not worth the risk.

But if the pubic fissure has spread by a maximum of 10 mm, the size of the pelvis is normal, and the fetus is small, natural childbirth is quite possible.

For baby
For a child, this pathology is not dangerous, except for the suffering of the mother during this period. Therefore, it is better to follow the doctor's recommendations to relieve symptoms, if only because your excitement and stress do not affect the baby's condition.

Treatment and prevention

To put it bluntly, it is difficult to fight this pathology. It is impossible to completely remove the diagnosis, if it is sufficiently pronounced. But to alleviate the symptoms, reduce the pain is quite realistic

Treatment of the disease will be as follows

Taking special drugs with a high content of calcium. But only in the later stages this is problematic, as there may be problems in childbirth, and the bones of the baby's skull will be stronger, which is undesirable during this period. Therefore, the doctor will select a compromise option, or the pregnant woman will take such drugs until a certain period.

Wearing a bandage. Limiting the usual physical activity, but at the same time, performing special exercises.

Taking anti-inflammatory drugs. Possibility of inpatient treatment.

To avoid the progression of the disease and protect yourself from pain and discomfort, you should listen to the following recommendations:

• distribute the weight evenly on both legs, do not cross your legs, do not sit in an asymmetrical position
• do not sit for more than an hour, change the position of the body
• avoid climbing stairs if possible
• don't sit on a hard
• move only back and forth, try to avoid deviations to the side
• in an acute attack of pain, sit in an easy chair or lie down on the bed
• do not walk a lot and do not stand for a long time

Prevention

will consist in a healthy lifestyle before pregnancy, sufficient consumption of foods high in calcium, playing sports.

Features of pregnancy and childbirth

Symphysitis is not a sentence, not a doom to suffering and not a guarantee of childbirth by CS

Regular monitoring by the doctor, following the recommendations, taking medications, inpatient treatment will reduce the risk of complications, relieve pain and discomfort.

Symphysitis often leads to childbirth by caesarean section, but you should not be afraid of this. Firstly, such childbirth will be prescribed with concomitant factors (large fetus, large divergence of the pubic fissure, narrow pelvis), and secondly, compared with the possible consequences, the operation is the safest method of delivery.

So, syphmisitis is not the rarest pathology of pregnancy. If a woman is faced with such a disease, she must remember:

• You can not be silent about the symptoms of the disease, a trip to the doctor is required!
• Symphysitis does not constitute a threat to the life and health of the child
• Comprehensive treatment will significantly alleviate the pain
• If the doctor insists on hospitalization, you should not refuse
• Often symphysitis is an indication for CS, but this is a necessary measure that will save a woman from tears in the pubic joint and subsequent difficult and lengthy recovery
• Avoid poses, positions that cause pain, walk less stairs, give up long walks

When a woman is carrying a child, she often experiences discomfort associated with her position. Sometimes painful sensations are just a natural reaction of the body to changes occurring in it. But it happens that pain in one or another part of the body may indicate serious health problems for the expectant mother.

What it is

Almost all pregnant women experience such an unpleasant symptom as pain in the lower abdomen, back or pelvis. And if at the beginning of pregnancy these sensations, in most cases, do not cause tangible discomfort and pass over time, then pain in the pelvis in the last months of bearing a child can be a sign of a pathology called symphysitis in obstetrics.

In medicine, symphysis is commonly called cartilage or fibrous tissue that connects the bones of the human skeleton. The pubic symphysis, or pubic articulation, is the cartilage that connects the two pubic bones, which are the constituent parts of the pubic bone. The pubic bone is one of the three bones that form the pelvis. In the normal state, the pubic joint is motionless. During the bearing of a child, a transformation occurs. In the female body, the hormonal background changes. Increased production of the hormone relaxin leads to the fact that the pubic joint becomes elastic, and the bones "diverge". This process is physiological, that is, it is so conceived by nature to prepare the birth canal of the female body for the passage of a child through it during childbirth. But sometimes the pubic articulation softens too much, and the bones "diverge" more than normal (5-6 mm). Sometimes such excess elasticity is accompanied by swelling of the pubic symphysis. This condition is called symphysitis during pregnancy. Most often it develops at the end of the second and third trimester.

Among the reasons for the development of symphysitis (or symphysiopathy) is also called a lack of calcium in the body of a pregnant woman. The catalyst for the disease can also be heredity or diseases of the musculoskeletal system that the expectant mother had even before the conception of the child.

What are the symptoms of this pathology, and how can symphysitis be determined during pregnancy? First of all, it is pain in the lower part of the pelvis, in the pubic area and perineum. Pain with symphysitis during pregnancy is first aching, gradually transforming into acute. Unpleasant sensations are aggravated by walking, especially when a woman needs to climb stairs. Over time, pain can make itself felt even during rest, when a woman rolls over, gets up or lies down, changes her body position. When pressing on the pubic bone, pain also intensifies. At the same time, a characteristic clicking sound can be heard. Symphysitis is often accompanied by swelling in the pubic area.

The easiest test to understand if a woman has symphysitis or not is to lie on her back and try to raise her straightened legs. If this cannot be done, then the pregnant woman most likely has symphysitis. However, do not self-diagnose. If you experience pain in the pelvis, it is better to contact your gynecologist. The doctor, if necessary, will send for additional studies in order to establish a more accurate diagnosis and prescribe adequate therapy.

Ultrasound for symphysitis during pregnancy

Pregnancy significantly limits the possibilities for a detailed examination of a woman. For example, it is impossible to do an x-ray or magnetic resonance imaging. Therefore, if symphysiopathy is suspected, the doctor sends the woman for an ultrasound examination. It is safe for both the expectant mother and her baby. This diagnostic method will help determine exactly how much the pubic bones have diverged.

There are three stages of symphysitis. At the initial distance between the pubic bones does not exceed 8-10 millimeters. In the second stage, the distance between the bones is from 1 to 2 centimeters, and in the third - more than two centimeters. Usually, with third-degree symphysiopathy, the pain is so severe that a woman cannot walk and sit.

Based on the data of ultrasound diagnostics, the doctor will prescribe a treatment for the woman.

Therapy of symphysitis during pregnancy may consist of various procedures, depending on the severity of the pathology. As a rule, it includes the use of anti-inflammatory drugs and vitamin complexes with calcium, diet and weight control, restriction (but not complete refusal) of physical activity, a set of physical exercises to relieve pain and strengthen the muscles of the pelvis, wearing a bandage. Sometimes women are recommended treatment in a hospital.

A bandage for symphysitis during pregnancy is a special bandage made of dense fabric, the task of which is to maintain the pelvic bones in a certain position and prevent their further divergence. It is selected individually for each woman. The bandage should be put on in the supine position so that it fits snugly enough. In this case, you should leave such a space between the bandage and the lower abdomen so that the palm can fit there. After fixing the bandage, you need to stand up and assess your feelings: the bandage should support, but not press. Wearing such a bandage is necessary only when you need to stand or walk for a long time. Under no circumstances should you leave it overnight.

Unfortunately, according to statistics, almost half of pregnancies occur with such a pathology. In addition, the situation becomes more complicated with each subsequent pregnancy. But with proper therapy and the implementation of all medical recommendations, some time after childbirth, symphysitis disappears.

What is dangerous symphysitis during pregnancy

This pathology is not dangerous for a baby growing in the womb. It poses a danger only to a pregnant woman. With a large divergence of bones, the pain syndrome is quite strong. A woman experiences pain and discomfort even when lying down. In addition, there is a risk of rupture of ligaments. As a rule, with symphysitis (second and third stages), a caesarean section is prescribed. After all, the risk of ligament rupture during natural childbirth for such women is quite high. After such a complication, the rehabilitation period is very long.

You can give birth on your own with symphysitis only if the divergence of the pubic articulation is less than one centimeter, and the fetus is small.

Symphysitis after pregnancy

In most cases, after childbirth, the hormonal background of a woman stabilizes - and the symphysitis disappears. Although there are cases when this pathology worries a woman even after the birth of a child. The following factors can lead to this condition: previous diseases of the musculoskeletal system, severe toxicosis during childbearing, a narrow pelvis in a woman, a large fetus, and so on.

As evidenced by the reviews of women who have encountered such a problem, with a slight discrepancy, wearing a bandage and special exercises helps to correct the situation. If postpartum symphysitis arose due to a sufficiently strong divergence of the pubic bones, then medical treatment may also be required. In any case, only an experienced doctor can prescribe adequate therapy.

Specially for -Ksenia Boyko