A 22-year-old G2 P1 presented to A & E with severe bilateral groin pain with associated frequency and dysuria on day 3 post partum. The groin pain was excruciating and even slight movement aggravated the pain. She had a normal delivery at 40+1weeks following spontaneous onset of labour and the baby weighed 3285g. Her first stage lasted 6hrs 45mts. Her second stage lasted 13mts and her third stage lasted 4mts.
Her BMI was 22 and height 1.46metres. On examination there was no erythema but acute tenderness over pubic symphysis and saphenofemoral junction. Pain increased when manual pressure is applied to the pelvis in latero-lateral and antero-posterior direction. Abduction of hips was limited to 22cms.
Antero-posterior x-ray of pelvis showed pubic symphysis diastasis of 16.4mm. Orthopaedic team was involved. She was treated conservatively with analgesics and braces which improved her symptoms.
Postpartum pubic symphysis diastasis is an uncommon disease. A diastasis wider than 14 mm indicates damage to sacro iliac joint and sacro iliac ligaments. Patients usually present with acute pelvic pain. Conservative treatment can provide good results. Few can develop chronic pelvic pain requiring surgical intervention.
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