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Symphysis pubis dysfunction (SPD), commonly known as pubic symphysis dysfunction or lightning crotch, [1] is a condition that causes excessive movement of the pubic symphysis, either anterior or lateral, as well as associated pain, possibly because of a misalignment of the pelvis.
The pubic symphysis is a nonsynovial amphiarthrodial joint. The width of the pubic symphysis at the front is 3–5 mm greater than its width at the back. This joint is connected by fibrocartilage and may contain a fluid-filled cavity; the center is avascular, possibly due to the nature of the compressive forces passing through this joint, which may lead to harmful vascular disease. [2]
Pubic symphysis diastasis (also known as diastasis symphysis pubis) is the separation of normally joined pubic bones, as in the dislocation of the bones, without a fracture that measures radiologically more than 10 mm. Separation of the symphysis pubis is a rare pathology associated with childbirth and has an incidence of 1 in 300 to 1 in 30,000 births.
The treatment of obstructed labour may require cesarean section or vacuum extraction with possible surgical opening of the symphysis pubis. [4] Caesarean section is an invasive method but is often the only method that will save the lives of both the mother and the infant. [18] Symphysiotomy is the surgical opening of the symphysis pubis.
Prior to the 20th century, specialists of pregnancy-related PGP used varying terminologies. It is now referred to as Pregnancy Related Pelvic Girdle Pain that may incorporate the following conditions: Diastasis of the symphysis pubis (DSP) Symphysis pubis dysfunction (SPD) Pelvic Joint Syndrome; Physiological Pelvic Girdle Relaxation
Symphysiotomy is a surgical procedure in which the cartilage of the pubic symphysis is divided to widen the pelvis allowing childbirth when there is a mechanical problem (obstructed labour). It is also known as pelviotomy [ 1 ] and synchondrotomy. [ 1 ]
Illustration of fundal height at various points during pregnancy. Fundal height, or McDonald's rule, is a measure of the size of the uterus used to assess fetal growth and development during pregnancy. It is measured from the top of the mother's uterus to the top of the mother's pubic symphysis.
Sagittal pelvic outlet diameter Same, but may require minor side-to-side scrolling to visualize both end points. The closest bony points of the sacrococcygeal joint and the pubic bone next to the symphysis. This is also called the obstetric anteroposterior diameter of the pelvic outlet, to distinguish from the anatomic one which includes the ...