ABSTRACT
Based on a review of the literature, a questionnaire was developed to create a scoring system for pregnancy-related symphysis pubis dysfunction (SPD) and completed by 150 (100 without SPD and 50 with SPD) peri-partum women. The questionnaire was tested for reliability in a sub-set of 21 women. Symptoms that were significantly associated with SPD were identified and used in a scoring system in order to diagnose patients with SPD. SPD was reported by 12% of patients in the first trimester, 34% in the second trimester and 52% in the third trimester. Significant symptoms in patients with SPD were: pubic bone pain on walking, turning over in bed, climbing stairs, standing on one leg, and previous damage to back or pelvis. Using a score of 1 for each of the above symptoms, a score of 2 and above was considered diagnostic of SPD. There was 1 false positive score. As SPD is a clinical condition with no definitive diagnostic test, there is a need for a scoring system that will allow patients to be assessed in terms of their symptoms. This system has the potential to facilitate screening, diagnosis and management of SPD as well as allow monitoring of the patient and assessment of the success of various interventions.
Subject(s)
Joint Diseases/diagnosis , Pregnancy Complications , Pubic Symphysis , Severity of Illness Index , Arthralgia/etiology , Female , Humans , Joint Diseases/complications , Mass Screening , Pregnancy , Pregnancy TrimestersABSTRACT
A review of the literature revealed a multitude of terms used to describe Symphysis Pubis Dysfunction (SPD). No unambiguous definition was found, rather the condition is described in terms of symptoms and signs. These occur due to the physiological pelvic ligament relaxation and increased joint mobility seen in pregnancy. The severity of symptoms varies from mild discomfort to severely debilitating pain. There appears to be no correlation between the degree of relaxation of the symphysis pubis and the level of pain and disability. Treatment is generally conservative and delivery is curative in the majority by 6 months post-partum. There is a need for standardisation of terminology, an agreed definition of SPD and a reliable means of assessment of the condition. Additionally there is a need for scientific evaluation of different forms of treatment.
