Facts: Parturition-Induced Pubic Diastasis/Pelvic Dislocation
- There is increased mobility of pubic symphysis and sacroiliac joints during pregnancy because of hormonal change
- During delivery, a rapid forceful descent of fetal head against the pelvic ring can result in this injury
- Patients experience immediate pain and audible snap during labor
- Mostly require conservative treatment with a pelvic binder, lateral recumbency and analgesics. In few cases, surgical fixation is used.
- Forceps assisted delivery, shoulder dystocia
- Maternal developmental dysplasia of the hip, prior pelvic trauma
- Separation of pubic symphysis >1 cm
- If separation >4 cm, usually associated with SI joint disruption
- Patients may have sacral fractures, lumbosacral plexus injury, bladder/urethral injury
Kharrazi FD, Rodgers WB, Kennedy JG. Parturition-induced pelvic dislocation: a report of four cases. J Orthop Trauma 1997;11:277-281.