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Symphysitis: symptoms and treatment, symptoms of symphysitis in pregnancy

What it is?

Symphysis is a fibrous or cartilaginous junction 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 fixed fixed state, but during pregnancy symphysis of the lumbar joint experiences great loads. As a result, the connection becomes mobile and sometimes gives a pregnant woman a lot of discomfort and pain. And, the lower the fetus is located, the more pressure its weight exerts on the bones.

In medical practice, this problem has the name "symphysitis". However, this diagnosis is not always placed and not all women expecting a child.

The fact is that the mobility of the bones is a natural condition in pregnancy, because the mother's body must prepare for childbirth and ensure that the child is unhindered from the mother's womb.

Therefore, Symphysitis during pregnancy is diagnosed only in cases where the discrepancy of bones exceeds the norm, and the lone articulation becomes edematous.


Symptoms of symphysitis in pregnancy


The first trimester of pregnancy does not yet have any effect on the bones of the heart. The fetus is still small, the uterus is only slightly enlarged, so the symphysis is in relative stability and calm.

From the middle of the second trimester, pelvic floor bones begin to experience stress, but the discoloration of the pubic joint rarely begins before the fifth month of pregnancy. From the 20th week the signs of symphysitis are felt and aggravated with an increase in the period.

  • Pain in the pubic area - almost always have a pulling, aching character. Increase when climbing the stairs, long walking and subside, if the future mother is at rest. If the symphysitis stage is started, the pain sensations persist throughout the day and tend to increase. Changing and the nature of manifestation - against the background of a constant aching pain there are lumbago, a feeling of jamming.
  • Puffiness - localized in the pubic area. As the disease progresses, the scales of the edematous area increase, and the edema becomes more pronounced and painful to the touch. It means the presence of the inflammatory process in the symphysis of the pubic articulation.
  • The severity of the lower abdomen is due to the process of discrepancy between the bones, swelling and the flow of blood to the small pelvis. In some cases, a pregnant woman can attribute this symptom to a threat of miscarriage and go to the hospital. The severity of the lower abdomen increases if the woman takes a vertical position and decreases at rest.
  • Sharp deterioration of the state under load - here there is a view of the load in the form of ascent to the ladder, lifting the legs in a prone position and standing. When the symphysitis stages are started, clicks can be heard, the pain becomes sharp and strong under the load. After the termination of loads within an hour, edema of the pubic zone may increase.

Explicit signs of the disease appear, mainly in the last two months of pregnancy. To suffer painful sensations it is impossible, it is necessary to address urgently to the doctor.

Symphysitis does not pose a threat to the life of the fetus, but it can cause disability of the mother after childbirth.

The causes of symphysitis

The cause of symphysitis during pregnancy, manifested in the second and third trimesters, can contribute to a number of factors:

Недостаток кальция – растущий плод испытывает большую потребность в кальции, который он берет из организма матери. 1) Lack of calcium - a growing fetus has a great 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 osseous system and joints. Such a situation can become a provocative factor in the development of the symphysite at a later date.

Нарушения опорно-двигательного аппарата – беременные, имеющие такие заболевания, находятся в зоне риска появления чрезмерного расхождения костей лонного сочленения. 2) Violations of the musculoskeletal system - pregnant women with such diseases are at risk of excessive discrepancy of the bones of the lone articulation. As an example, we can cite future mothers with complex forms of infantile cerebral palsy (tetraparesis, lower paraparesis).

Movement of such patients is associated with certain difficulties, and posture, for physiological reasons, can not be direct.

This leads to an uneven distribution of the load, which gives the growing fetus, provoking a divergence of the bones at a distance exceeding the permissible norm.

Высокие показатели релаксина – во время беременности, особенно с приближением родов, яичники и плацента начинают активно вырабатывать этот гормон, который необходим женщине для того, чтобы она перенесла появление малыша на свет. 3) High indices of relaxin - during pregnancy, especially with the approach of labor, the ovaries and the placenta begin to actively develop this hormone, which is necessary for a woman to transfer her appearance to the light.

In some cases, the production of relaxin is superfluous, so the ligaments become more elastic and the bones become more fragile. Suffering and symphysis, the consistency of which becomes softer.

Degrees of symphysitis in pregnancy, characteristic symptoms

Degrees of symphysitis in pregnancy

On examination, the doctor not only can diagnose, but also will determine the stages of the disease. After all, symphysitis is a serious pathology of the bone system of a woman and her treatment will depend on how difficult the situation is in a particular case.

Symphysitis 1 degree suggests that the distance between the pubic bone is 5 - 9 mm. A pregnant woman may experience the following symptoms:

  • Drawing pains in the region of the heart with long walking.
  • Slight puffiness.
  • Unpleasant sensations in the lower abdomen after climbing the stairs

The first degree is considered easy, it is not dangerous to the health of the mother, and all the inconveniences go away if the woman reduces the load or rests. In some patients symphysitis does not progress, but a doctor's observation is still necessary to correctly assess the situation and not miss the moment if the distance between the pubic bones begins to increase.

Symphysitis of the 2nd degree suggests that the gaps inside the pubic articulation increased to 15-20 mm. The following symptoms correspond to it:

  • The pain is present constantly: at rest they become less tangible, and in a state of stress - more pronounced.
  • Noticeable swelling in the area of ​​the heart.
  • The severity of the lower abdomen, which accompanies the pregnant woman constantly, except for the time when she is lying down.

At the second stage, natural births are in question - the risk of rupture of the pubic joint is too great. Most maternity hospitals will prefer to do a caesarean section in this case, and only specialized research institutes, equipped with advanced technologies, equipment and high-class doctors, will venture into a natural birth.

Symphysitis of the 3rd degree is considered to be the heaviest and involves a divergence of the bones of the heart for a distance exceeding 20 mm. Symptoms are pronounced:

  • Painful, at times giving lumbago in the leg.
  • Extensive edema.
  • Constant heaviness in the lower abdomen.
  • Clicks on palpation of the affected area.

The third degree means that the birth will be performed only with the help of Caesarean section, and until this moment the patient is given complete peace and bed rest.

Each stage of symphysitis during pregnancy has its own symptoms, but it is impossible to determine the degree of the disease on its own - it should only be done by a doctor.

Symphysitis after childbirth

Excessive divergence of pubic bones can make itself felt not only during pregnancy, but also in the postpartum period. This can happen for several reasons:

  • An easy degree of symphysitis, diagnosed during pregnancy. Natural childbirth in this case is not prohibited, but sometimes they can trigger a worsening of the disease, especially if the fetus was large.
  • During pregnancy there was the 2nd stage of symphysitis, but for some reason the doctors decided to let the woman into natural childbirth. Even with a normal weight of a child, this is often the cause of worsening of the disease in the postpartum period.
  • During pregnancy there was no discrepancy of the bones, but in the body the woman lacked calcium or during childbirth had a large release of the hormone relaxin, which led to the development of the disease after the baby's birth.

It is important to visit the doctor on time, because the 2nd and 3rd degree of symphysitis after delivery can worsen so much that it will lead to disability and to keep the "duck gait" for life.

Symphysitis treatment

Symphysitis treatment

Therapy with symphysitis has 3 main goals: reduction of pain, exclusion of factors that provoke further discrepancy of bones and return of bones of the lone articulation to the former place.

  • Anesthesia - prescribe drugs in injections or tablets to reduce pain. Among them: No-shpa, Ketorol, Baralgin, Paracetamol. To avoid getting used to drugs, they are recommended only if the woman has to spend a lot of time on her legs.
  • Changing the regime - the patient, depending on the severity of the symphysitis, will prescribe either a bed or a semi-postal regime. If an easy degree of disease is diagnosed, the doctor will advise to reduce the daily load. Change of regime is necessary in order for the lonnoe articulation to be in relative rest.
  • Restoring the previous position of bones - postnatal symphysitis, most likely, will require wearing a special bandage, whose action will be aimed at reducing the gap between the bones. At stage 3 of the disease, in addition to the bandage, the doctor will prescribe a cane or crutches.
  • Physiotherapy - applies electrophoresis, massage, as well as the execution of a course of exercises that will be individual for each patient. To connect the bones can be applied CMT (stimulation of the muscles with electric current), although one of its side effects will be a temporary feeling of stiffness of the muscles of the thighs.

Symphysitis is a disease that it is better to start treatment immediately than to wait for a critical condition. After all, the outcome of the treatment will largely depend not only on the movement of the woman, but also on her ability to endure another pregnancy.


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