- Introduction
- Anatomy and Structure
- Symptoms
- Cause
- Implications for Malpositions and Cesareans
- Tips for Coping with Pubic Symphysis Pain
- Possible Treatments
- Traditional Approach
- Chiropractic
- Osteopathic
- Other Alternatives
- Planning For Birth
- Other Common Questions
- How often does a separated pubic symphysis occur
- Is this condition related to my build or size
- Should I have an elective cesarean
- Should I stop breastfeeding if I am still experiencing pubic pain postpartum
- Will this tenderness last after the birth
- Will I get this problem back with every pregnancy
- Postpartum
- Women"s Stories
- References
- Resources
- 产妇骶髂关节痛及耻骨联合分离,为什么?
- 作者:陈华|发布时间:2012-09-20|浏览量:1886次
http://www.plus-size-pregnancy.org/pubicpain.htm
这是一篇介绍产妇产后为什么发生骶髂关节痛以及耻骨联合分离的文章,文章阐述了发生的原因以及处理的原则。希望能够对广大患者对产后疼痛有所理解、如何正确对待。北京301医院骨科陈华
Pelvic Pain (Symphysis Pubis Dysfunction)
by KMom
Copyright © 2001-2003 KMom@Vireday.Com. All rights reserved.
Last updated: April 2003
DISCLAIMER: The information on this website is not intended and should not be construed as medical advice. Consult your health provider.
CONTENTS
下面是几个患者的亲身经历:
Women"s Stories
Paula"s Story
I was one of the "fortunate" ones to be experiencing pubic symphysis pain, but I started going to my chiropractor again and VOILA! I am a new woman!!
I will tell you that my pain was so bad there were days that I didn"t think I was going to be able to get out of bed and actually had to roll out of bed and onto the floor to be able to do so! I went to a different chiropractor just to "see what he offered" and my appointments consisted of maybe 2 adjustments and that was it---less than 5 minutes in his office---and it took me 20 to drive there! He wasn"t very open-minded about listening to my concerns or answering questions, so I chose to go back to the chiropractor I have been going to since I was 13. He knew exactly what was going on and I kid you not, within one adjustment, I could actually move my legs without feeling like I was going to die of excruciating pain. I have been seeing him for almost a month now, twice a week, and I am almost completely pain-free!!! For those of you who are experiencing pelvic pain, please go see a chiropractor!!
M"s Story
I had a cesarean with my first baby for breech. [With my second child,] I had severe pain in my pubic bone bad enough that I could barely walk...I felt TREMENDOUS pressure on my pubic bone while pushing with him, it was as significant as the ring of fire. Thank God I was in a squat so I could stop when it hurt too much!...[I also arched my back as I pushed.]
This time, when it started getting bad, I saw a chiropractor and it was gone the day he adjusted me...The spinal adjustments were normal for me, but the pressing on my abdomen was very painful. The Webster entails getting the back in alignment then releasing knots in the abdominal muscles. The muscle part hurt a lot. {Kmom note: Most women don"t find it painful; this is an interesting difference}
I think it was instrumental in [my third child] being vertex [head-down]. I"m pretty sure that she was breech the Thursday before I went into labor. I"d had the Webster done because I thought that it couldn"t hurt her positioning. I felt BIG movement once I got to the receptionist"s desk [after the Webster]. So who knows what was going on!
[Follow-up Note: M had a cesarean with her first child for breech; her second child (10 lbs. plus!) was born by VBAC, despite significant pubic pain. Her third child (the one she saw a chiropractor for because of breech) was also born by VBAC. Her fourth child was recently born by VBAC at home.]
Jill"s Story
I had pubic symphysis dysfunction with both my pregnancies. Had chiropractic with my second PG---helped me to not have the sciatica I"d had the first time but I still had lots of pain when rolling over in bed, lifting one leg, lots of clicking and popping that was very unpleasant. (I"ve always had a misaligned pelvis...and my chiro worked on it constantly but within days of an adjustment it would slip back. I think if I"d been getting chiropractic care from birth, it"s likely I wouldn"t have such problems with my pelvis now.)
I was at-risk for having [pubic symphysis damage]. Luckily I had a home birth and was not forced into lithotomy or stirrups, so it didn"t happen. I think that what can happen to cause the ligaments to tear is that in lithotomy position, the sacrum and coccyx can"t move as they normally would to allow the baby"s head through, so the only other thing that can move is the pubic symphysis, and when it is forced to move too far, it tears the ligaments. Just my own little personal theory.
This is probably "too much information", but I pushed on hands and knees and my DH said he could *see* my sacrum and coccyx move back---said my butt got kind of square when she crowned. :-)
[Jill had her first baby by c/s because of breech. Her second baby was born by VBAC at home.]
Veronica M"s Story
Kmom"s Notes: (This is a drastically shortened version of Veronica"s stories. The full version can be found under BBW Malposition Stories on this site.) Veronica experienced SPD symptoms in both of her pregnancies. Although it is not documented in her records, Veronica probably experienced a malpositioned baby with her first birth. It was able to resolve and the baby was born vaginally, but being placed in stirrups probably damaged her pubic symphysis, worsening her condition.
The SPD pain was worse in the second pregnancy, but was brushed off by her provider. Again, she had a malposition, but this time the problem was documented as the nurses saw that the baby"s hand was by its head as it was crowning. They put her on her back and pulled her legs back forcefully to her ears. This is called a McRobert"s position. If the baby has trouble getting out this position can be useful, but in this case the baby"s head was already crowning easily when the nurse did this so it was probably not necessary. Unfortunately, pulling the legs apart so strongly and back so far meant that the pubic symphysis joint got damaged long-term. Afterwards, her doctors dismissed or discounted the pubic pain, since few U.S. doctors know about DSP.