Symphysitis during pregnancy symptoms. Symphysitis - symptoms and treatment. Description and symptoms of the disease

With the onset of pregnancy, serious changes occur in a woman's body. The hormonal and immune systems are being rebuilt the most. But sometimes expectant mothers are faced with problems of the musculoskeletal system, which include the disease symphysitis.

What is symphysite

The pubic articulation of a woman (or symphysis) in the normal state is motionless. But during pregnancy, the body produces the hormone relaxin, which prepares the body for childbirth: it relaxes the pelvic bones to form the birth canal. In some cases, the symphysis becomes overly mobile, becomes inflamed, and the pubic bones are widely diverged. Then they diagnose symphysitis (or symphysiopathy). Today, doctors cannot say with certainty why there is inflammation and stretching of the symphysis. Most experts agree that a lack of calcium is the main cause. Some also note the role of a hereditary factor and the presence in the history of a pregnant woman of injuries of the musculoskeletal system before conception. Plays an important role excess weight the expectant mother or his quick set during the period of bearing the baby.

The relationship between the manifestations of symphysitis and age has not been established.

Symphysitis symptoms during pregnancy

Many women experience short-term pubic pain during the third trimester. This is considered normal, as the pelvic bones prepare for the birth process: they expand and the fetal head sinks lower. The following symptoms should alert you:

frequent pain in the pubic region (pulling or sharp when trying to get out of bed, turn on one side);
a soft crunch, accompanied by pain when pressing on the pubic bone;
pain when walking or other physical activity;
change in gait (it becomes "duck", unhurried, neat, which helps to avoid shooting pain in the pubic pelvis);
swelling in the pubic area;
pain during intercourse;
inability to raise one or both legs from a lying position.

With symphysitis, the pubic bones soften and become too mobile

Can symphysitis appear in early pregnancy

Inflammation and distension of the symphysis can manifest itself in any trimester and even after childbirth. Most often, this diagnosis is made starting at 25 weeks. If a woman had symphysitis in a previous pregnancy, the likelihood of recurrence of symptoms is high. More often in such cases, pain and discrepancy of the pubic bones appear earlier.

Despite the enormous inconvenience and severe pain that symphysitis causes, the disease does not affect the development of the fetus and its health.

How to determine symphysitis during pregnancy: taking anamnesis, consultations of narrow specialists, ultrasound

At the slightest sign of symphysitis, a woman needs to contact a gynecologist, and on his recommendation, an orthopedist-traumatologist. The most reliable diagnostic method is X-ray. However, it is contraindicated during pregnancy. Therefore, first of all, the doctor relies on the results of the examination and anamnesis. After that, an ultrasound examination (ultrasound) is performed, during which the degree of divergence of the frontal bones is studied:

the first one is 5-9 mm;
the second is 10–19 mm;
the third - 20 mm or more.

How to give birth with a diagnosis

Symphysitis affects the delivery process. Most often, with the disease, a planned cesarean section is prescribed. Doctors sometimes hear a pregnant woman's disagreement with the prohibition on natural childbirth, although the risk is high: when the child passes through the birth canal, the symphysis may rupture, and this can cause complications:

severe pain;
damage by the edges of the bones of the urinary canal and bladder;
hemorrhage in the joint area, which in the future threatens to develop into arthritis;
the need to comply with strict bed rest for several weeks.

Natural childbirth is allowed only if the following factors are present simultaneously:

the discrepancy of the bones is no more than 10 mm;
medium-sized fruit (less than 4000 g);
the pelvis of a woman is of normal size.

Treatment of the disease

Unfortunately, it is impossible to completely eliminate symphysitis. The goal of treatment is to relieve pain and prevent increased stretching. The first degree is easier than others to therapy. In some cases, it is enough to adhere to the following recommendations:

reduce physical activity and get more rest;
change the position of the body more often (pain in the pubic area intensifies if you stand or sit for a long time);
if possible, sleep on an orthopedic mattress;
take vitamins and calcium as directed by a doctor;
do special exercises to strengthen the pubic articulation;
eat right, preventing an increase in body weight above normal.

With the second and third degrees of the disease, the following are added to the intake of vitamins and a balanced diet:

strict bed rest;
wearing a special bandage;
taking anti-inflammatory and analgesic drugs (most often such treatment takes place in a hospital).

In inpatient treatment, the main focus is on physiotherapy - magnetotherapy and special massage.

Medicines for the treatment of symphysitis

The main function of drugs prescribed during this period is to relieve pain and make up for the lack of calcium and vitamin D in the body. Among them:

Nurofen in children's dosage;

Medicines prescribed in the treatment of symphysitis of the second and third degrees - photo gallery

The use of Aquadetrim (vitamin D) must be monitored by a doctor: its excess can harm the fetus
Nurofen for children can be used as an anesthetic, but only in the first and second trimesters of pregnancy Calcemin is prescribed to strengthen the bones of a woman Panadol is used to relieve symptomatic pain

Physical exercises

The need for exercise and their complex is determined by the doctor. Physical activity is aimed at strengthening the pelvic floor muscles, reducing pain and preventing further divergence of the pubic bones:

"Cat" - take the original knee-elbow position (kneel and elbow, straighten your back and shoulders in one line). Smoothly arch your back in an arc, lowering your head down and at the same time straining your stomach. After five seconds, return to the starting position;
“Striving upward” - lie on your back, put your hands along the body, bend your legs at the knees. Focusing on your hands, slowly raise your pelvis up. Hold in this position for three seconds, then lower the pelvis;
kegel exercises - training the muscles of the vagina by compressing them. In addition to the benefits for symphysitis, this technique helps prepare the body for childbirth.

Exercising with symphysitis without first consulting a doctor is dangerous.

Exercises for pregnant women - video

Wearing a bandage

Wearing a bandage is one of the mandatory measures in the treatment of symphysitis. It is prescribed during pregnancy and after childbirth, so that the pubic bones quickly fall into place. When choosing a bandage, you need to know certain rules:

such a design is selected individually depending on the degree of the disease;
before buying a bandage, you need to try it on in order to understand how comfortable it is;
put it on only while lying down, tightening it tight. In a standing position, a woman should feel the tight support of the pelvic bones;
the bandage is not worn constantly, but is used only when you need to walk a lot.

Home remedies for pubic discrepancy

Home treatments for symphysitis include certain foods that are rich in calcium:

cheese, best of all goat (it can be added to salads from fresh vegetables, put on sandwiches or eat as a separate dish);
fish (steamed or baked);
cottage cheese (casseroles, mousses, cakes are prepared from it or consumed fresh);
almonds, if there is no allergy to this nut;
prunes.

Unripe almonds can be dangerous, as they can cause severe poisoning, and bitter nuts contain a substance that, when ingested, turns into potassium cyanide - a powerful poison.

Sesame with honey

Small sesame seeds are rich in calcium, so they can be made into a simple, tasty and healthy dish for symphysitis. You need to mix 100 grams of sesame seeds with a small amount of unsweetened honey (to taste). This mixture can be eaten during the day or left in the refrigerator overnight, having previously decomposed into molds. The honey will harden and you will get sesame kozinaki.

Prevention of the onset and development of the disease

It is impossible to prevent the appearance of symphysitis. This is due to the fact that the exact reasons for the discrepancy of the pubic bones are unknown. However, you can strengthen the pelvic floor muscles, reduce pain, and prevent symphysis rupture. To do this, doctors advise:

plan a pregnancy (before conception, undergo a full examination, pass tests for latent infections, check the functioning of the thyroid gland, tell the gynecologist about previous pregnancies and whether there were signs of symphysitis before);
at the planning stage and during gestation, ensure a sufficient intake of vitamins into the body (as recommended by a doctor), eat well and balanced;
undergo all recommended ultrasound examinations;
regularly visit an obstetrician-gynecologist, and if signs of illness appear, immediately inform him about it;
with a confirmed diagnosis, adhere to all medical recommendations.

When carrying a child, a woman may find discomfort and pain in the pubic area. Often these sensations are of high intensity, leading to limitation of activity. The reason for this is the movable bones of the symphysis of the pubic bone, which, under the influence of various provoking factors, diverge too far. Such a pathology can significantly worsen a woman's well-being during pregnancy, complicate childbirth.

Overview of Symphysitis in Pregnancy

In the region of the chin, sacrum, pubis, sternum and intervertebral discs, there is a symphysis - a cartilaginous or fibrous connection between the bones of the skeleton. During pregnancy, in the area of \u200b\u200bthe pubic articulation, it weakens. This process is normal as it helps the woman prepare for childbirth. With intense exertion, symphysiopathy can develop during pregnancy. The disease is characterized by the separation of bones over a long distance, the formation of edema. Symphysitis brings discomfort to the expectant mother, accompanied by pain, limited mobility.

Symphysitis signs during pregnancy

The first signs of the disease appear at the 4th month of pregnancy, the complete clinical picture is found in the 3rd trimester. The following common symptoms of symphysitis are distinguished:

Swelling in the pubic area. At first, it appears slightly. An increase in the symptom occurs as the inflammatory process develops.
Pain in the pubic area. Has a aching, pulling character. The symptom worsens when climbing stairs, walking for a long time. If a woman is at rest, the pain gradually subsides. With an advanced stage of symphysitis, the nature of sensations changes, a feeling of pinching, lumbago appears. The discomfort persists throughout the day.
Severity in the lower abdomen. It is formed under the influence of a rush of blood to the small pelvis, edema and the process of bone separation. This symptom of symphysitis increases when the woman takes an upright position, decreases at rest.
Clicks, crunching, sharp pain. They arise during physical exertion or when touching an inflamed area. After a decrease in motor activity, the formation of edema is possible.

Causes of symphysitis during pregnancy

Modern scientists cannot identify the exact factors affecting the formation of symphysitis. The following are the probable causes of the development of the disease during pregnancy:

Lack of calcium. Having a great need for this element, the growing fetus draws it from the mother's body. With its critical deficiency, a woman develops joint and bone pathologies. For this reason, symphysitis develops in late pregnancy.
Increased level of relaxin. The production of this hormone occurs actively before childbirth. The substance is necessary for the female body in order to favorably transfer the process of the baby's birth. The production of this hormone is in some cases excessive. As a result, the consistency of the symphysis softens.
Diseases of the musculoskeletal system. The discrepancy of the pubic symphysis during pregnancy often occurs in women with such pathologies. Difficulties in movement, curved posture of the patients lead to the fact that the load given by the fetus is unevenly distributed, therefore, symphysitis is formed.

Along with the main causes of symphysitis, risk factors are distinguished, in the presence of which the likelihood of illness during pregnancy increases significantly. Among them:

urogenital infections;
low physical activity of a woman;
child's weight exceeding 4 kg;
frequent childbirth;
previous injuries to the pelvic bones;
the presence of pathology in a previous pregnancy.

The degree of divergence of the pubic articulation

On examination, the doctor can determine not only the presence of an ailment, but also the degree of its severity. Symphysitis in pregnant women has the following stages:

First degree - the distance between the pubic bones varies from 5 to 9 millimeters. This stage is characterized by pulling pains with prolonged walking, localized in the bosom, swelling of small severity. After climbing the stairs, the patient may experience discomfort in the lower abdomen. The disease at this stage is not dangerous for a woman, its symptoms disappear with a decrease in the intensity of the load, sufficient rest. A pregnant woman should be under the supervision of a doctor in order to prevent the progression of the pathology.
The second degree is characterized by an increase in the gaps inside the pubic articulation up to 15-20 millimeters. The disease is manifested by pronounced edema, constant pain (the intensity depends on the woman's activity during pregnancy), heaviness in the lower abdomen, which occurs when the body is upright. At this stage, the likelihood of rupture of the pubic articulation increases, so natural childbirth is not recommended.
The third degree is severe. It is characterized by the separation of the bones over a distance of more than 20 millimeters. At stage 3, pronounced symptoms appear: pain, lumbago, extensive edema. When palpating (probing) the inflamed area, specific clicks are found. With 3 degrees of symphysitis, childbirth is carried out only with the help of a cesarean section. For the period of pregnancy, the patient must be provided with rest, bed rest.

Symphysitis treatment during pregnancy

It is impossible to completely cure the disease during pregnancy, but the implementation of some recommendations will help to significantly alleviate the patient's condition. At the first stage of symphysitis, it is necessary:

ensure bed rest, minimize physical exercise during pregnancy, the patient needs to spend more time alone;
take easily digestible calcium supplements, B vitamins;
apply procedures with ultraviolet light;
regularly perform exercises aimed at strengthening the pubic articulation;
for the period of pregnancy, choose orthopedic mattresses for sleep;
avoid being in one position for more than 60 minutes, long walking;
take pain relievers that are safe during pregnancy as needed.

The treatment strategy for stages 2 and 3 of symphysitis during pregnancy involves keeping the pelvic bones as close as possible. If severe pain occurs, a woman can be admitted to a hospital. In the hospital, it is necessary to undergo courses of medications with anesthetic and anti-inflammatory effect, physiotherapy. If therapy is carried out on an outpatient basis, pregnant women suffering from symphysitis, it is recommended:

strictly observe bed rest;
wear a special corset, bandage or apply tight bandage;
eating a diet that includes foods high in calcium
take painkillers and vitamin preparations, appointed by a specialist, allowed during pregnancy.

Physiotherapy

Lie on your back, pull your feet to your buttocks, bending your knees. Spread the lower limbs at a slow pace, fix the position for 30 seconds, then bring it together again. Repeat the exercise 6 times.
Move the heels away from the buttocks by 30-40 cm. Raise and lower the pelvic area. Movements should be slow. On minimum distance from the floor, try to hold your position as long as possible. The pelvis should be raised by 2-3 cm. Repeat the exercise 6 times.
Do the Cat exercise. Get on all fours. Keep your spine straight and relax your back. Do not lower or raise your head. Arch your back while contracting your thighs and abdominal muscles. The head must be raised. Do 3 reps.

Pregnancy for many women is filled with happiness from the feeling that develops inside new life, and the joy of waiting for a child. But there are situations that can darken this period and disrupt the usual rhythm of life. During pregnancy and childbirth, various disorders in a woman's body are possible, including traumatic tissue damage. Among the latter, there is a pathology of the pelvic bones called symphysitis or symphysiopathy. A woman, when faced with such a diagnosis for the first time, may become seriously alarmed. And information about the causes of pathology, possible risks and methods of correction should eliminate the ambiguity in this matter.

Causes and mechanisms

The female pelvis is under great stress during pregnancy. In the second and even more so the third trimester, there is an intensive growth of the uterus and fetus. The weight of a woman by the time of expected birth can increase to 15 kg, and all this mass for the most part falls on the pelvis. To reduce the stress on the tissues, the body produces the hormone relaxin, which relaxes the ligaments, tendons and muscles. But there is also back side this phenomenon - there is a razvlecheniya, edema and serous oozing of the articular surfaces, which increases the likelihood of divergence of the pubic articulation.

Normally, the symphysis is semi-mobile. It is formed by pubic bones connected by a fibrocartilaginous disc. The latter is strengthened by ligaments that have grown into it. But as a result of hormonal changes during pregnancy, the prerequisites are created for symphysitis, that is, divergence of the pubic bones. This risk increases from 36 weeks of gestation, when the baby begins to descend into the pelvic cavity. Its presenting part exerts pressure on the pubic junction, expanding the pelvic ring.

An important factor in the development of symphysitis is considered a deficiency of trace elements during pregnancy, primarily calcium. The child requires its active intake, especially during the formation of the skeletal system. If a woman has difficulties with nutrition, then calcium is removed from bone and cartilage tissue. Thus, the articular surfaces, including the symphysis, become weaker and may be subject to traumatic injury. There are other factors that contribute to the divergence of the pubic articulation. These include:

A child weighing more than 4 kg (large).
Multiple pregnancy.
History of frequent labor.
Anatomically and clinically narrow pelvis.
Connective tissue dysplasia.
Inactivity (lack of exercise).
Pelvic trauma in the past.
Rapid labor.
Operative delivery.

Most often, a combination of several factors occurs: the physiological mobility of the symphysis, which occurs against the background of some aggravating moment. Each woman has individual characteristics of the body, which must be taken into account in diagnostic measures.

The origin of symphysitis is described by several aspects: the physiological state of the pubic articulation and the influence of additional factors.

Classification

Any diagnosis is made on the basis of generally accepted classifications, as for obstetric pathology. Symphysitis during pregnancy has certain morphological features. Its severity is established based on the magnitude of the discrepancy between the pubic bones:

I degree: 6-9 mm.
II degree: 10–20 mm.
III degree: more than 20 mm.

This is established using additional research methods, since it is impossible to clinically measure the distance between the articular surfaces. In addition, there is symphysitis not associated with pregnancy. Similar cases are observed in professional athletes (runners) or pelvic injuries.

Signs

As it became known, the discrepancy of the symphysis is a pathology that is characteristic mainly for the third trimester of pregnancy. The severity of the clinical picture is determined by the degree of pathology. The woman experiences the following symptoms:

Pain in the pubic region, aggravated by bending the legs and changing the position of the body, radiating to the lower back and hip area.
Walking disorders: "duck" gait, walking with small side steps, difficulty climbing stairs.
Inability to raise straight lower limbs from a prone position.

The woman takes a forced position, in which it is easier for her - on her back with thighs apart and knees slightly bent (Volkovich's pose). On examination, swelling in the pubic region is revealed, soreness and deepening between the parted bones are determined by palpation.

An unpleasant consequence of symphysitis can be a rupture of the ligaments that hold the joint. At the same time, serious disorders in motor function develop, because a woman completely loses the ability not only to stand on her feet, but also to walk independently. This is due to the broken integrity of the pelvic ring. At this place, a hematoma can form due to rupture of small vessels, which, moreover, sometimes festering.

Untreated pathology becomes the cause of the formation of a pseudo-joint between the pubic bones with the subsequent disability of patients.

Additional diagnostics

Diagnostic measures for symphysitis are quite few. Without taking into account clinical methods based on the analysis of anamnestic information and objective data, there is only one additional study applicable to a woman in position - this is an ultrasound of the pubic symphysis during pregnancy. It is thanks to the echographic picture that it is possible to identify the discrepancy of the bones and determine the degree of pathology. And radiography, taking into account the radiation exposure, is contraindicated. But in the postpartum period, its use is not prohibited.

Additional diagnostic measures for symphysitis include ultrasound examination of the symphysis pubis.

Correction

To avoid the progression of symphysitis and reduce its clinical manifestations, early and active treatment is necessary. What activities should be used, the doctor will say. And a woman should diligently follow them, because this is one of the aspects of successful therapy.

Conservative

With a slight damage to the symphysis, a woman is recommended to change her position in bed: in turn, lie on the left and right side. At the same time, a flat pad with sand is placed on the area of \u200b\u200bthe greater trochanter to accelerate the convergence of the bones. And you can be on your back no more than 2 hours a day. It is effective to use a hammock, in which the convergence of the symphysis is achieved due to the patient's own weight. In addition, other events are shown:

Medicines (non-steroidal anti-inflammatory drugs, calcium supplements, vitamins).
Therapeutic exercises (to strengthen the muscles of the pelvis, lower back and lower extremities).
Physiotherapy (magnetotherapy).
Wearing a special bandage.

Thus, a complex conservative therapy is used, which gives good results in uncomplicated cases and makes it possible to significantly improve the woman's condition.

Surgical

If the patient has a serious discrepancy of the pubic articulation, there is a large fetus and an anatomically narrow pelvis, then she will not be able to give birth to a child through natural routes. In such cases, a caesarean section is necessary. Surgical methods are indicated when a purulent process occurs at the site of a hematoma - a puncture with drainage is done. And ruptures of the pubic ligaments, which in fact are a type of pelvic fracture, even require artificial fixation by means of osteosynthesis.

Symphysitis that occurs during childbearing is a fairly common problem in obstetrics. Faced with her, a woman will have to experience a lot of unpleasant sensations that limit her life. But to prevent this from happening, it is better to follow the preventive recommendations: lead healthy image life, eat right, do light gymnastics and regularly see a doctor.

Do you have sharp pains in the pubic area, it became difficult to turn from side to side, and gait is like a duck? Perhaps you symphysitis ... What kind of disease it is, how to recognize it and what to do in order to improve the condition of the expectant mother, we will tell you in our material.

Getting to know the concept

Nature has foreseen everything very wisely, so the female body prepares for the process of childbirth in advance throughout the entire period of pregnancy.

One of the unique preparatory steps is softening interosseous pelvic joints. This process - natural , thanks to which the child in the process of delivery will easier to pass through the bones of the pelvis.

However, sometimes the pubic symphysis stretched too much , swells, and pubic bones diverge. It is in the case of such a development of symptoms that the expectant mother appears severe pain in the pubic area, because of which it is difficult for her to move and get up.

In this case, we are talking about the disease "symphysitis". Symphisite - softening of the pelvic joints and pubic symphysis under the influence of the hormone relaxin. The name of the disease comes from the word "symphysis", the so-called fixed sedentary joint that connects the pubic bones of the pelvis.

Gritsko Marta Igorevna, candidate of Medical Sciences , obstetrician-gynecologist human reproduction clinics "Alternative" tells:“Symphysitis is not a very common disease. For 8 years of work in the department of pathology of pregnant women, I have had the only such case. The cause of symphysitis is unknown, but most specialists are inclined to hormonal changes in the second half of pregnancy. Under the influence of the hormone relaxin bone may soften and stretch the pubic articulation. This is a normal process in the body of a pregnant woman preparing for childbirth. However, if the pubic joint swells strongly and is too mobile, then pain occurs in the pubic bone and the entire small pelvis, "duck gait", pain when walking, etc. This pathology does not affect the development of the fetus in any way, the pregnant woman needs to wait for childbirth, after which the symptoms go away on their own. Gentle mode, wearing a bandage - this is almost all that can be advised. The obstetrician-gynecologist chooses the way of delivery based on the course of pregnancy. "

Causes and symptoms of the disease

So, unfortunately, the unambiguous and only reason why this disease occurs in pregnant women has not yet been clarified.

Besides hormonal changes , doctors often say that symptoms of symphysitis develop as a result lack of calcium in the female body, which, as you know, is actively spent by the baby for the development of its skeletal system and teeth.

A decrease in calcium in the blood of the expectant mother can be observed with lack of vitamin D , diseases gastrointestinal tract, chronic enteritis, dysfunction of the parathyroid gland, renal failure, diabetes mellitus, as well as with a diet with insufficient calcium content, vomiting of pregnant women and other conditions.

Also, do not forget about individual characteristics of the body structure , factor heredity and possible problems of the expectant mother with the musculoskeletal system in the pre-pregnancy period.

Symphysitis symptoms during pregnancy

Most often, symphysitis manifests itself in the trimester of pregnancy and is characterized by the following symptoms:

pain in the pelvis, pubic bone, groin and tailbone;
pain when changing the position of the body;
pain and clicks when pressing on the pubic bone;
swelling in the symphysis area;
pain while climbing stairs;
characteristic "duck" gait, walking in small steps;
it is difficult to raise your legs in a lying position.

As the disease progresses, the pain becomes stronger and can manifest itself not only when moving, but also in a sitting or lying position.

You should not diagnose yourself on your own, if you notice one or more of the above symptoms in yourself, see a doctor .

During the examination, the doctor must do an ultrasound of the pubic joint, the results of which draw conclusions about the possibility of natural childbirth or the need for a cesarean section. In the results of a blood test, the concentration of calcium and magnesium is often reduced by almost half, and their content in the urine is slightly increased.

Symphysitis of the first degree diagnosed with a divergence of the bones of the pubic articulation by 5-9 mm., second - 10-20 mm., third - with a discrepancy of more than 20 mm. The second and third degree of discrepancy - indication for caesarean section ... Natural delivery with symphysitis is possible if the discrepancy between the pubic dissection is no more than 10 mm, and the fetus is small.

Symphysitis treatment in pregnant women

Symphisite - a disease that in no way does not affect the development of the baby ... Although it is not easy to deal with it, more often than not everything symptoms of the disease disappear after childbirth by themselves.

However, the main problem with symphysitis is the question - are it possible in this state , or you will have to resort to help.

Natural childbirth is possible if the pubic slit has expanded by no more than 10 mm., The fetus is medium-sized, and the pelvis of a pregnant woman is of normal size. However, it is worth remembering that with natural delivery pubic articulation may separate , which means that a young mother will need a long rehabilitation period.

Most often with symphysitis pregnant women are advised taking complex vitamins with calcium preparations, limiting physical activity, a special diet, wearing a bandage.

They can help relieve pain a few simple guidelines :

when sitting, do not cross your legs;
when standing, distribute the weight evenly on both legs;
do not sit or lie on hard surfaces;
it is not recommended to sit for more than an hour, as well as walk or stand for a long time;
avoid slopes and stairs;
while lying down, first turn the shoulders and upper torso, and then the pelvis;
control;
eat foods rich in calcium (dairy, fish, nuts, sesame seeds, dried apricots);
take walks if possible (in the skin under the influence sunlight Vitamin D is produced, which is necessary for normal calcium metabolism);
sleep on a comfortable, better orthopedic mattress.

Also, with symphysitis, especially 1-2 degrees, if possible, it is recommended to do set of special exercises to strengthen the muscles of the pelvis, lower back and thighs.

Lying on your back, bend your knees and pull your feet as close to your buttocks as possible. Slowly spread your knees to the side, and then slowly return them to their original position. Repeat the exercise 6-10 times.
The starting position for the next exercise is the same as for the previous one, only the feet need to be slightly set back from the buttocks. Slowly lift the pelvis up, and then slowly return to its original position. In the later stages, it is enough to simply tear the pelvis off the floor and slowly return it back. Repeat the exercise 6-10 times.
Get on your knees, rest your hands on the floor, relax your back. It is important that the back, pelvis, neck and head are at the same level. Bend your back up, lower your neck and head down. The muscles of the abdomen and thighs should be tense at the same time. Repeat the exercise 3 times.

Important : Do not do any without the permission of your doctor. For some forms of symphysitis, complete absence of movement is the best solution.

We hope that our tips will help you, and that your pregnancy will be easy and will go away without problems!

Symphysitis is considered a pathology of the pubic articulation, the development of which is based on an inflammatory response in response to the influence of a damaging factor. Physiologically, the connection between the pubic bones of the pelvis is a fixed structure, however, due to various conditions, it is possible to increase its mobility.

This process is caused by a change in the consistency of the ligaments, acquiring a softer shape, as well as the swelling of this area. As a result, the pubic bones gradually move away from each other, and their articulation becomes more mobile.

Most often, such changes are observed during pregnancy or after childbirth. In the case of a slight discrepancy of the bones, it is possible to independently restore the anatomical location. However, sometimes the distance between the bones exceeds 1 centimeter, which requires complex treatment.

During pregnancy, symphysitis can occur from the second half of the term. This is due to the rapid weight gain of the fetus and an increase in amniotic fluid. As a result, a force is constantly exerted on the pubic joint, which contributes to the divergence of the pubic bones.

If symphysitis is observed after childbirth, then this is most likely a consequence of trauma to the joint during labor as the fetus passes through the birth canal.

Symphysitis reasons

It is rather difficult to identify the exact cause of the development of pathology, since several factors can simultaneously affect the occurrence of symphysitis. So, the causes of symphysitis may lie in the excessive secretion of the hormone relaxin during pregnancy. As a result, the ligaments become softer and lose the ability to tightly hold the bones at the desired distance.

A similar process occurs due to a change hormonal background and imbalance of its components. Also, the development of symphysitis can be facilitated by genetic factors that are hereditarily transmitted to a woman.

Causes of symphysitis such as insufficient levels of calcium and other trace elements in the body of a pregnant woman can provoke the discrepancy of the pubic bones.

A high likelihood of developing symphysitis is observed in pregnant women with pathology of bones and joints. You should also not forget about the course of pregnancy, since severe toxicosis, rapid weight gain, excessive exercise and improper nutritional intake can lead to an increase in the distance between the pubic bones and excessive mobility of the pubic junction.

Pubic symphysitis

The hormonal system is one of the main regulating factors for the functioning of the body. During pregnancy, it is rearranged, and the ratio of hormones changes. These processes are necessary in order to provide all the necessary conditions for the growth and development of the fetus.

In the process of hormonal changes, the predominance of the production of certain active substances is possible. So, with excessive synthesis of the hormone relaxin, pubic symphysitis is observed.

Its development is due to the softening of the ligamentous apparatus, due to which the pubic pelvic bones are at a certain distance from each other. So, as the tone decreases, there is a divergence of the pubic articulation and an increase in its mobility.

Pubic symphysitis is also possible in diseases of the bones and joints, when a woman has a predisposition to the development of symphysitis, especially if she has insufficient calcium levels in the body.

Normally, the distance between the pubic bones increases slightly. This is necessary to ensure passage for the fetus through the birth canal. In addition, the method of delivery depends on the degree of divergence of the pubic articulation, since natural childbirth with a large distance between the bones can lead to such complications as ligament rupture.

Symphysitis symptoms

The beginning of softening of the ligaments between the pubic bones can be observed already from the 6-7th months, since it is during this period that clinical signs of pathology appear. Symphysitis symptoms, under certain unfavorable circumstances, may disturb from the 4th to 5th months.

At the initial stage, the pregnant woman feels aching periodic pain in the perineum and pubis. They bother with vigorous walking or climbing stairs. Further, the pain syndrome increases due to the fact that the mobility between the pubic bones increases.

The pain becomes permanent and is observed not only with physical activity, but at rest or a change in body position. In addition, there is discomfort in the area of \u200b\u200bthe pubic articulation. In the future, the pregnant woman acquires a "duck" gait. It helps her to use less pubic junction when walking, thereby reducing pain impulses.

Symphysitis symptoms become more pronounced in the last months of pregnancy, when the force acting on the pubic bones is at its maximum. Pain can spread to the hip, lumbar, groin, and gluteal regions.

Symphysitis of pregnant women

The process of bearing a fetus is a serious burden on a woman's body. During this period, a restructuring of the hormonal system is observed, as a result of which an exacerbation of the existing concomitant pathology of the endocrine system is possible.

In addition, the body of a pregnant woman is exposed to stress from the fetus, since an additional circle of blood circulation appears, as the fetus grows, the uterus gradually rises and in the last stages it reaches the diaphragm, as a result of which it becomes more difficult for a woman to breathe (the respiratory volume of the lungs decreases).

The enlarged uterus also prevents the normal outflow of venous blood from the lower extremities by affecting the blood vessels. In general, the body is undergoing major changes and you should not be surprised if a slight malfunction is possible somewhere.

So, symphysitis of pregnant women is a fairly common pathology, the development of which is based on the relaxation of the ligamentous apparatus that connects the pubic pelvic bones. The diagnosis is made using symptoms and the results of additional instrumental studies.

Postpartum symphysitis

During pregnancy, many factors affect the ligamentous apparatus between the pubic bones of the pelvis, as a result of which it loses its tone and the ability to keep them at a certain distance.

In the case of a discrepancy of the bones no more than 1 centimeter, you can carry out the delivery through the natural way. It sometimes happens that the distance between the pubic bones increases after childbirth.

Postpartum symphysitis occurs as a result of the influence of factors from both the fetus and the pregnant woman. Excessive stretching of the ligaments is facilitated by a large fetus, a narrow pelvis of a woman, severe toxicosis, previous pathology of joints and bones, as well as many other factors.

If the discrepancy has occurred by several centimeters, then with the help of special exercises and a bandage, you can soon get rid of the symptoms of symphysitis or even himself.

Postpartum symphysitis, caused by a significant distance between the pubic bones, requires complex treatment, which includes drug therapy, physiotherapy, wearing a bandage and exercise.

Complications of symphysitis

The divergence of the pubic bones can have varying degrees, the most serious complications of symphysitis are observed when the distance between the bones is exceeded by more than 1 centimeter. Starting from the first stage, the appearance of a pain syndrome is noted, which periodically worries and has an aching character.

At this stage, the pregnant woman can fight the pain with special exercise and pain relievers. However, as the process progresses and the distance between the pubic bones increases, the pain syndrome becomes constant, regardless of the woman's activity.

Since the pain is observed even at rest, the psychoemotional state is disturbed in the pregnant woman, she becomes irritable and whiny. In addition, the nervous system undergoes the influence of hormonal levels, which change significantly during pregnancy.

Such complications of symphysitis, such as excessive divergence of the pubic bones up to rupture, are severe consequences of ligamentous pathology. As a result, the symphysis pubis loses the connection between its structures, which leads to the inability to walk, stand, or raise the legs.

Symphysitis diagnostics

The process of making a diagnosis includes a thorough questioning of a woman about her complaints, the duration of the disease, as well as identifying the provoking factors that caused the development of symphysitis.

Diagnosis of symphysitis consists of additional instrumental research methods that are used depending on the position of the woman. That is, if a woman is pregnant, then some studies are not allowed, for example, an X-ray method, computed or magnetic resonance imaging. In this case, she is recommended exclusively to carry out ultrasound diagnostics.

In the case of the development of pathology after childbirth, then the diagnosis of symphysitis can use all the methods that are necessary for the diagnosis. With their help, not only the divergence of the bones of the pubic junction is determined, but also the distance between them is estimated.

As a result, after conducting research, further therapeutic tactics are determined. Based on the ultrasound diagnosis of the pregnant woman, the method of delivery is determined, based on the degree of divergence of the pubic bones.

Ultrasound for symphysitis

During pregnancy, it is necessary to exclude all factors that may have a negative effect on the fetus. So, it is allowed to use exclusively ultrasound diagnostics with different purposes (to control the condition of the fetus and amniotic fluid, as well as to determine the pathology of the pregnant woman).

Ultrasound for symphysitis is the only method that is allowed to be used without harming either the fetus or the future mother. This method is used to determine the degree of divergence of the pubic bones and measure the distance between them.

Thus, with the help of ultrasound with symphysitis, it is possible to identify the first degree of discrepancy, which is characterized by the discrepancy of the pubic bones of no more than 5-9 millimeters. In the second stage, there is a distance from 1 centimeter, and in the third - more than 2 centimeters.

With symphysitis of the third degree, a woman cannot walk, sit and raise her legs, since all these actions cause severe pain. Based on the data obtained after the ultrasound examination, the further tactics of the woman's management, as well as the treatment directions, are determined.

Symphysitis treatment

Depending on the degree of divergence of the pubic bones and clinical manifestations pathology, the treatment of symphysitis can include various methods of assistance.

A prerequisite for therapy is the performance of specially designed physical exercises that reduce the intensity of the pain syndrome, strengthen the gluteal, perineal, femoral and lumbar muscles. Thanks to them, the pelvic structures restore their physiological position.

Symphysitis treatment implies the implementation of some recommendations. Among them, it is necessary to highlight: a decrease in physical activity, in particular, climbing stairs and brisk walking, do not sit in one position for a long time (more than 1 hour), do not place one leg on top of the other in a sitting position, and evenly place the load while standing on both legs.

In addition, you need to monitor your diet and eat more foods containing calcium - dairy products. Also, calcium can be taken in tablet form. It is necessary to control your weight, since excess weight predisposes to the appearance of severe pain syndrome.

Among medications, anti-inflammatory drugs and complexes of vitamins and microelements should be noted.

Bandage for symphysitis

Therapeutic tactics are determined in each case individually, taking into account the degree of divergence of the pubic pelvic bones and the severity of the clinical manifestations of symphysitis. Despite the distance between the bones of the pubic articulation, there are some therapeutic methods that must be used.

A special set of physical exercises and a bandage are the essential components of the treatment complex. The bandage for symphysitis is used to maintain the pelvic structures in a physiological position and prevent further separation of the pubic pelvic bones.

The bandage for symphysitis is a bandage made of dense material that is able to hold the pelvic bones in a certain position.

However, there are some peculiarities. So, the bandage must be selected for each pregnant or postpartum woman individually, during which she needs to try it on and determine how comfortable it is.

Firstly, the bandage should be put on in a supine position, while fastening rather tightly, leaving room for the palm to enter. Secondly, when lifting, it is necessary to assess how tightly it fits and supports the pelvic structures.

And, finally, thirdly, the bandage should not be used around the clock, but only if you have to stand or walk for a long time. At night, the bandage must be removed to avoid excessive compression of the internal organs.

Exercises for symphysitis

Excessive physical activity is strictly prohibited, as it contributes to an even greater divergence of the pubic pelvic bones and increased pain.

On the other hand, specially selected exercises for symphysitis can not only reduce the severity of pain, but also strengthen the ligaments and increase the tone of the muscles of the perineum, buttocks, thighs and lower back.

Exercises for symphysitis must be performed several times a day, especially with severe pain syndrome. The complex includes several exercises that can help in the fight against symphysitis.

First, you need to take a supine position and place your feet as close to the buttocks as possible. Then you should slowly spread your knees to the sides, hold them in the maximum permissible position and close them again. You can repeat it from 5 to 10 times, gradually increasing the number of exercises.

Next, you should set your feet slightly away from the buttocks so that the lower leg forms a right angle with the floor, and raise the pelvis until a straight line with the body is obtained. However, you need to control the lifting height to avoid discomfort. Repeat up to 6-10 times.

The third exercise is known to all as "kitty". It involves performing on your knees and resting on the palm of your hand, arching the back upward, while lowering the neck and head. In this case, the muscles of the press should be tense. So you should stay for 5 seconds and repeat 3 times.

Symphysitis treatment with folk remedies

The pathology of the divergence of the pubic pelvic bones is based on the influence of pathogenic factors that contribute to an increase in the distance between the bone structures.

To combat symphysitis, they mainly use not medications, especially at the first stage, but folk remedies. Treatment of symphysitis with folk remedies includes performing a set of specially selected physical exercises, observing correct diet power supply, as well as the use of a bandage.

The effectiveness of these methods depends directly on the woman and the seriousness of the approach to treatment. So, by regularly performing exercises, she will soon strengthen the muscles of the buttocks, perineum, lower back and thighs, which is necessary to restore the physiological location of the pelvic structures.

In addition, due to daily exercises, the frequency of which reaches 3-4 times a day, they help to reduce the intensity of the pain syndrome.

Also, the treatment of symphysitis with folk remedies involves the use of food products that contain a high percentage of calcium. As for the bandage, it is an integral part of treatment and is necessary to maintain the pubic pelvic bones in a normal position, gradually bringing them closer to each other.

Prevention of symphysitis

Identification of the main influencing factor on the development of symphysite is a rather problematic task. In this regard, the prevention of symphysitis also cannot be clearly indicated.

Adhering to some rules and recommendations, it becomes possible to reduce the risk of pathology. So, first you need to reduce the number of loads and perform special physical exercises. Such a course should be selected by a specialist individually for each woman, taking into account her concomitant pathology and contraindications.

In addition, the prevention of symphysitis consists in adhering to the correct diet and lifestyle. It is necessary to eat foods with calcium and spend enough time in the fresh air.

In addition, pregnant women should wear a bandage to maintain the physiological location of bone structures and internal organs, and also not neglect the implementation of special exercises.

Symphysite forecast

The divergence of the pubic pelvic bones is observed in almost 50% of all pregnancies. It was noted that each subsequent pregnancy is more and more predisposed to the development of symphysitis. So, if during the first bearing of the fetus, softening of the ligamentous apparatus was already revealed, then subsequent pregnancies will also be accompanied by this process.

The prognosis of symphysitis depends on the degree of divergence of the pubic bones and the clinical manifestations that bother the woman. If measures are taken in time to solve this problem, then the prognosis of symphysitis is quite favorable.

In addition, during pregnancy, a woman is under the constant supervision of a doctor who monitors the development of symphysitis and decides on the choice of the method of delivery. Pathology does not have a negative effect on a woman's health, provided that symphysitis is controlled.

After childbirth, there is a stabilization of the hormonal background, a decrease in the swelling of the pubic articulation and a decrease in the severity of pain.

Symphysitis is observed in half of all pregnancies, but subject to proper attention to pathology and selection effective treatment, a woman, several months after giving birth, may not remember about symphysitis.

Symphysitis and sex

As already mentioned, symphysitis develops as a result of exposure to various provoking factors, which leads to a softening of the ligamentous apparatus between the pubic pelvic bones.

Divergence of bones is accompanied by pain syndrome, which makes symphysitis and sex mutually exclusive processes. Pain interferes with the woman's relaxation and enjoyment, which leads to greater nervous tension and irritability.

Even if symphysitis is at the first stage of development and painful sensations do not arise during sexual activity, there is still a high probability of their appearance after sex.

As for the second and more stages of pathology, here sex will contribute to the intensification of the pain syndrome, which always accompanies a woman. This is especially true for active sex and intense movement.

Of course, with symphysitis, physical activity is necessary, only in the form of special exercises aimed at gradually strengthening the ligamentous apparatus and muscles. They are performed slowly and do not cause painful sensations to a woman, but, on the contrary, help to reduce their severity.