Abscess formation after symphysis pubis diastasis in pregnancy: A case report

Abstract

Introduction: Abscess formation afterpubis symphysial separation in normal vaginal delivery is rare, and few cases have been reported in the literature. In this study, a case of abscess formation following pubis symphysis separation in normal vaginal delivery is reported that was successfully treated after identifying the infection causative organism. Case presentation: The patient was a 23-year-old female referring to Besat Hospital Clinic, Sanandaj, with pain, swelling, and redness of the suprapubic region following second normal delivery along with increasing fever and chills. The patient reported pain and difficulty in movement before delivery, which increased after delivery. Clinical examination of the patient showed pain, sensitivity, and swelling at the suprapubic region. In laboratory studies, inflammatory markers were elevated. The patient underwent ultrasound, which showed rectus sheath hematoma and edema. The pelvic X-ray showed a pubic symphysis separation of 20 mm. The patient underwent Spire ultrasound, which indicated an abscess. In the sample culture, Streptococcus viridans was grown. The patient was treated with antibiotics imipenem and vancomycin. Due to the lack of fever, pelvic abscess was diagnosed, so a laparotomy was performed and a drain was inserted. On day 35 of hospitalization, the patient underwent X-ray before discharge; the results of the X-ray indicated a 10-mm pubic symphysis separation. The patient was discharged in good condition. Conclusion: In pregnant or postpartum women with general symptoms of infection, the presence of septic symphysis should be suspected and immediate and comprehensive action should be taken to treat it..

Keywords

• infection
• joint dislocations
• pregnancy complications
• pubic symphysis diastasis