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A case report: post-partum symphysiolysis, a rare complication of labour


Background: Pubic symphyseal widening spontaneous vaginal delivery is normal. The stretch that occurs after delivery is less than 10mm. However, separation of symphysis of more than 10 mm is rare and can cause injury to the pubic bone and pelvic floor muscles. The prevalence of pubic symphysis injury is 1 in 300 to 1 in 30,000 live births. Thus, in this study we report a post-partum symphysiolysis as a compilation of labour.

Case Description: A 34-year-old woman G5P4004 40th weeks gestational, came to Lewoleba Hospital, Lembata was referred with complaints of lacerations and pain in the upper pelvis after vaginal delivery of a male baby with a birth weight of 4,000 grams at the Public Health Service. On physical examination, there was a rupture of the vulva-vaginal wall anterior to the pubis with active bleeding. There is limited ROM in both lower extremities. Then an operative procedure was carried out in the form of repair of the ruptured vulva-vaginal wall to stop the bleeding and repair the anatomical structure of the external genitalia. After the operative procedure, a pelvic radiological examination was performed, which revealed a stretch in the right and left superior ramus pubis ostium with a size of 5.5 cm. The patient underwent conservative measures by placing a splint on the pelvis for one month. After six months, a follow-up was performed, the stretch became 3.5 cm and the patient's complaints were no longer felt.

Conclusion: Symphysiolysis is a very rare obstetric complication. Complaints of pain in the pelvis that arise after childbirth, accompanied by a decrease in the ability to mobilize the lower extremities, can indicate symphysiolysis. A pelvic radiological examination confirms the diagnosis. Conservative management is the main choice in the treatment of symphysiolysis


  1. Marshall SA, Senadheera SN, Parry LJ, Girling JE. The Role of Relaxin in Normal and Abnormal Uterine Function During the Menstrual Cycle and Early Pregnancy. Reprod Sci. 2017;24(3):342-354.
  2. Pedrazzini A, Bisaschi R, Borzoni R, Simonini D, Guardoli A. Post partum diastasis of the pubic symphysis: a case report. Acta Biomed. 2005;76(1):49-52.
  3. Agten CA, Metzler C, Rosskopf AB, Zanetti M, Binkert CA, Prentl E, et al. MR imaging of pubic symphysis after uncomplicated vaginal delivery and planned caesarean delivery in the first postpartum week. Clin Imaging. 2019;56:58-62.
  4. Kearney R, Miller JM, Ashton-Miller JA, DeLancey JO. Obstetric factors associated with levator ani muscle injury after vaginal birth. Obstet Gynecol. 2006;107(1):144-149.
  5. Jayaraman JK, Ganapathy P, Indira N. Post-Partum Diastasis of the Pubic Symphysis: Report of a Rare Case. J Clin Diagn Res. 2015;9(9):QD09-QD10.
  6. Buitendyk M, Brennan B, Vora P, Smith P, Winsor S. Acute intrapartum rupture of the pubic symphysis requiring resuscitation and surgical intervention: a case report. J Obstet Gynaecol can. 2018;40(1):68-71.
  7. Hierholzer C, Ali A, Toro-Arbelaez JB, Suk M, Helfet DL. Traumatic disruption of pubis symphysis with accompanying posterior pelvic injury after natural childbirth. Am J Orthop (Belle Mead NJ). 2007;36(11):E167-E170.
  8. Rustamova S, Predanic M, Sumersille M, Cohen WR. Changes in symphysis pubis width during labor. J Perinat Med. 2009;37(4):370-373.
  9. Aydın S, Bakar RZ, Aydın ÇA, Özcan P. Assessment of postpartum symphysis pubis distention with 3D ultrasonography: a novel method. Clin Imaging. 2016;40(2):185-190.
  10. Herren C, Sobottke R, Dadgar A, Ringe MJ, Graf M, Keller K, et al. Peripartum pubic symphysis separation--Current strategies in diagnosis and therapy and presentation of two cases. Injury. 2015;46(6):1074-1080.
  11. Sanjaya INH, Pemayun CIM, Purwanti NWD, Sakuntari MDV, Gianni NPN, Putri NLMDMC, et al. Single Umbilical Artery (SUA) - prenatal sonography diagnosis and vascular imaging features postnatal cord: a case report. Bali Medical Journal. 2021;10(1):8-10.
  12. Osterhoff G, Ossendorf C, Ossendorf-Kimmich N, Zimmermann R, Wanner GA, Simmen HP, et al. Surgical stabilization of postpartum symphyseal instability: two cases and a review of the literature. Gynecol Obstet Invest. 2012;73(1):1-7.

How to Cite

Mulia, M. B. P., Maria Florentina Tukan, & Amvisena Gatot. (2022). A case report: post-partum symphysiolysis, a rare complication of labour. Intisari Sains Medis, 13(2), 659–661.




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Made Bayu Prasetia Mulia
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Maria Florentina Tukan
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Amvisena Gatot
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