Carrying a child is a huge challenge for the female body. Most of the obvious changes do not have to be explained, but sometimes some changes in the body of the expectant mother cause concern. One of these exciting factors that needs special attention is the pubic articulation. Where is the pubic symphysis located, what are the reasons for the possible appearance of pain in its area and how to deal with it, every pregnant woman should know.
Pubic symphysis
The pubic joint, which also has a second name - the pubic symphysis, is two pubic bones of the hip joint, connected by fibrocartilaginous tissue along the midline. It is located in front of the bladder above the external genital organs and is attached to the pelvic bones with elastic ligaments.
A woman's body in the prenatal period is subject to dramatic changes that affect her hormonal balance. The result of exposure to hormones such as progesterone and relaxin is the softening of all ligaments. The pubic joint, where the cartilage is located, also becomes less static. Often this leads tounnatural painful mobility of the pubic symphysis.
During pregnancy, the purpose of exposure to these hormones is to increase the flexibility of the joints and bone structure, which contributes to an easier flow of labor. Meanwhile, dysfunction of the pubic symphysis is rare in patients and requires immediate action.
Disconnection of the pubic symphysis
The appearance of space between the pubic bones is called a discrepancy. Such a diagnosis is subject to ascertaining on the basis of the complaints described by the pregnant woman. Symptoms often include:
- pain in the pubic area, which can respond with unpleasant aching sensations below, "pull" the leg and groin;
- sudden pain during exertion movements (turning from side to side, climbing stairs, etc.);
- a kind of cracking of the joints is possible when the hip moves;
- painful pressure on the pubic bone.
To obtain more accurate diagnostic data, an ultrasound of the symphysis pubis and MRI should be performed.
The latter will help determine the degree and width of the discrepancy, which can reach one of three levels:
- 1 - width is 5-9 mm;
- 2 - width is 10-20mm;
- 3 - width over 20 mm.
Causes of pubic symphysis divergence
The pubic articulation during pregnancy is threatened due to impaired metabolism and lack of vitamin D. For example, hormones,produced by the parathyroid gland, are involved in the regulation of phosphorus-calcium metabolism in the body. In the event of a lack of calcium intake, required for the full development and growth of the fetus, the body begins to draw the necessary substance from the mother's reserves. The main source of calcium for the unborn baby will be mother's teeth and bones. Also, diseases of the gastrointestinal tract and diabetes can cause a lack of calcium. In turn, vitamin D significantly affects the absorption of incoming calcium by the body.
The pubic symphysis divergence begins to develop long before the birth of the child. However, the effect of hormones and the weight of the fetus contribute to the manifestation of the above symptoms only in the II or III trimester. Often, the signs of pathology that have appeared are not given due attention and are attributed to osteochondrosis, sciatica, and the threat of abortion.
Timely diagnosis is essential. It will help to take the necessary treatment measures in time, prevent negative consequences through natural delivery or resort to a caesarean section.
Treatment of discrepancy
Usually, when the pubic bones diverge, no intervention is required. After a successful birth, the flexibility, elasticity and integrity of the pubic symphysis can be restored naturally.
Recommendations from OB-GYNs to reduce excessive stress on joints and ligaments include:
- wearing a brace;
- doing gymnastic exercises;
- assignmentnecessary medications (magnesium, calcium, vitamins, especially group B).
A woman in labor should inform obstetricians about the presence of this pathology before the start of labor.
The divergence, which has passed into a more severe degree, is fraught with a rupture of the pubic articulation. To avoid further separation of the pubic bones, doctors also strongly recommend limiting physical activity, preferring bed rest.
Rupture of the pubic symphysis
If the divergence of the pubic bones is observed mainly during gestation, then a rupture is possible during the birth process.
Among the varieties of breakups are violent and spontaneous. The latter occur during spontaneous labor activity. The reason for the appearance of violent ruptures is often called the use of additional efforts when extracting the fetus, manual separation of the placenta. In addition, the introduction of a hand into the uterine cavity in most cases is a decisive factor in the probable rupture of the pubic articulation.
Treatment of ruptured pubic symphysis
When a rupture occurs, the patient needs strict bed rest. The area of the hip joint is subject to tight bandaging. It is optimal for this purpose to use a linen wide bandage. On the back of the bed, you should install the legs and attach blocks to them at the level of the pelvis. The ends of the bandage must be tied on wooden planks, which are tied with cords. These cords pass through the blocks, and to their endsit is necessary to hang the load, starting with a couple of kilograms and gradually increasing to 10 kg.
Due to the early recognition of the rupture, the restoration of the pubic joint occurs in 2-3 weeks. In the case of delayed treatment, the bandage is applied for at least 1 month. Often for this purpose, bandages are used from a cloth resembling a hammock. Its edges are attached to the longitudinal slabs. The pelvic bones begin to converge due to the gravity of the patient's weight. The recovery time for staying in a hammock is the same.
The musculoskeletal functions of the pelvis are fully restored with the treatment approach carried out without delay. With a more backward definition of a rupture, the inflammatory process of cartilage tissues contributes to difficult fusion and protracted rehabilitation.
