Management und Geburtsmodus bei symphysendehnung in der Schwangerschaft

Peripartum symphysis separation is a well-known complication of pregnancy. Incidence is estimated ranging from 1:300 to 1:30000. The underlying etiology is not fully eludicated and seems to be multifactorial. Hormons and their dysbalance might play an important role. Despite of characteristic symptoms (pubic pain, radiation to the back and legs, gait problems) during pregnancy and after delivery, damages are often neglected. In order to prevent long-term disability, early diagnosis and intervention is necessary. Radiographic documentation confirms the clinical history and diagnosis and is useful for follow-up. Conservative therapy (bedrest, pelvic binders, analgesics, physiotherapy, acupuncture) is superior to surgical treatment. In most of the cases complete recovery is achieved within three months. The occurrence of symphyseal separation should not alter the mode of delivery and should be adapted to the symptoms. Without additional problems caesarean delivery is not indicated. This management is also recommended for subsequent pregnancies.