K. Bjorklund et al., Sonographic assessment of symphyseal joint distention during pregnancy andpost partum with special reference to pelvic pain, ACT OBST SC, 78(2), 1999, pp. 125-130
Objective. To elucidate whether there is a relationship between pregnancy-r
elated pelvic pain and degree of symphyseal laxity.
Methods. Forty-nine women were interviewed and examined and ultrasonographi
c measurement of symphyseal width and vertical shift was conducted at 12 an
d 35 weeks of pregnancy and at 5 months post partum. The patients were retr
ospectively classified into four groups on the basis of presence and degree
of pain in late pregnancy and presence or absence of pain at follow up.
Results. The prevalence of pelvic pain of any degree during pregnancy was 4
9%, of pronounced pain 16.3% and of severe pain 6.1%. Nineteen percent had
any remaining pain at 5 months post partum. The median symphyseal width at
12 and 35 weeks of pregnancy and at 5 months post partum was 3.5 mm, 4.6 mm
and 2.8 mm, the median vertical shift 0.0 mm, 0.8 and 0.9 mm respectively.
Those with disabling pain during pregnancy and no pain at follow up had gre
ater symphyseal width (6.3 mm) and vertical shift (1.8 mm) at 35 weeks of p
regnancy than controls; 4.5 mm (p<0.01) and 0.5 mm (p<0.01) respectively. T
hose with disabling pain during pregnancy and persistent pain at follow up
did not differ significantly from controls in symphyseal width or shift. Th
e most severe cases were in this group.
Conclusion. There is a minor pregnancy-induced physiological increase in la
xity of the symphyseal soft tissue. There is no evidence that the degree of
symphyseal distention determines the severity of pelvic pain in pregnancy
or after childbirth.