Pelvic ring stabilization in the peripartum injuries

Abstract

Background: Parturition-induced pelvic injuries after spontaneous vaginal delivery sometimes happen causing deformation of the pelvic ring. The frequency of these lesions is from 1:300 to 1:30000 births, creating many problems for young women in postpartum life. Material and methods: Under our follow-up there were 14 patients with disruption to the pelvic ring II-III degree during labor. Special bed position was recommended for the patients (n=4) with rupture of the pubic symphysis II degree. Sacroiliac joint subluxation was reduced by manual traction in multiparous patients (n=3) with disruption of III degree. Closed pelvis osteosynthesis by external device was performed. Results: Osteosynthesis was performed in trauma clinic, taking into account that patients had breast-fed children. The maximum anesthesia time was up to 30 minutes. Closed reposition of the pelvic bones and stabilization by an external device without additional blood loss were performed. Reposition of damaged bone surfaces was achieved in all cases. In 3-4 hours after surgery, the patients were returned to their children. From the second day they were able to get up, move around the room, take care of the children. Long-term results of treatment were evaluated from 1.5 to 14 years and rated as good. Conclusions: Rupture of the pelvic ring in women during childbirth requires qualified diagnostics and appropriate treatment. Conservative treatment does not give stable clinical result in multiparous women with disruption of II degree.