![]() ![]() Most women’s pain regresses over the first 1–6 months post partum, with 25% having pain 4 months post partum and only a small number after 12 months. 4 Women who develop SPD during pregnancy generally have a good prognosis, as delivery is usually curative. The onset of pregnancy-related SPD can vary, with 74% in a first pregnancy and 12% in the first trimester, 34% in the second trimester and 52% in the third trimester. 2, 3 The disability related to symphysis pubis pain in pregnancy can vary from mild to severe, but is significant and any therapy that can help to reduce the discomfort is a welcome possibility. 2 It is often confused with diastasis pubis (a separated symphysis pubis of more than 10 mm, or symphysiolysis), pelvic rupture (rupture of the symphysis pubis and sacroiliac joints simultaneously, which is extremely rare), and even osteitis pubis (partial or complete rupture of the symphysis pubis and requires aggressive treatment). ![]() SPD has been long recognized as an obstetrical condition in the literature but, until recently, there has been a lack of clinical interest. This case report will use SPD as its main descriptor, since this was the primary complaint in both cases. 1, 2, 3 There are many terms describing pelvic pain in pregnancy, including peripartum pelvic pain, Pregnancy-related Pelvic Pain (PRPP), Pregnancy-related pelvic girdle pain (PGP), anterior or posterior pelvic pain, and symphysis pubis dysfunction (SPD). 1 The reporting of symphysis pubis pain is also rising due to low reports in the past and/or greater recognition by practitioners. 1, 2, 3 Pubic symphysis dysfunction has been reported in 31.7% of pregnant women. The incidence of pelvic pain in pregnancy has been reported as between 48–71%. La patiente 2 ne ressentait presque plus de douleur mise à part une rare ré-exacerbation de la douleur au niveau de la symphyse pubienne. Après un suivi à long terme, la patiente 1 n’a constaté aucune douleur au niveau de la symphyse pubienne, mais une lombalgie consécutive à une blessure du genou. Les exercices post-partum et de réadaptation ont été prescrits afin de restaurer l’endurance musculaire, le contrôle et la stabilité pelvienne. Les deux patientes ont constaté un certain soulagement à la suite du traitement et des soins prodigués chez elles. ![]() Chez elles, on leur avait conseillé de mettre de la glace, de rester actives, de bouger tous les membres en même temps, de faire des étirements, de placer un cousin entre les genoux en dormant, de ne pas rester trop longtemps en position assise et de pratiquer des exercices pelviens au sol (Kegel). Leur traitement comportait entre autres une thérapie des tissus mous, le port d’une ceinture de soutien de grossesse, des mobilisations en position couchée sur le côté, des cales pelviennes, et des réajustements de la symphyse pubienne assistés par des instruments. ![]()
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