Divergence of the pelvic bones during pregnancy. Pelvic pain in pregnant women: causes and methods of elimination Does the pelvis expand during pregnancy?

Changes in the musculoskeletal system during pregnancy are caused by an increase in the mass and volume of the uterus, as a result of which the center of gravity of the body shifts. A woman's spine straightens, and lumbar lordosis appears (the curvature of the spine with its convexity facing forward). The chest expands and the ribs rise. Changes also occur in the bone tissue itself associated with shifts in the phosphorus-calcium balance and increased blood supply to the bones. The process is accompanied by loosening of the connective tissue of the articular ligaments and cartilage. Similar changes occur under the influence of the hormone relaxin, which is formed in the placenta.

A woman's mobility in the sacral joints increases. In the last stages of pregnancy, the pelvic bones soften and expand slightly. This process is reflected in the gait; it becomes “duck-like.” The lumbosacral joint also changes its position and becomes mobile. The pubic bones also diverge. All these changes contribute to an increase in the size of the pelvic inlet for easier passage of the fetal head during childbirth.

Pain when expanding the pelvic bones

The divergence of the pelvic bones occurs due to changes in the soft tissue structures; subsequently, the ligaments in the area of ​​the pelvic joints become increasingly relaxed. Normally, this condition may be accompanied by slight pain. As the pelvis expands, the tailbone becomes mobile and leans back; as a result, a woman may feel discomfort in this area when sitting for long periods of time. Pain is less pronounced in women who, before conception, played sports, led an active lifestyle, and followed a balanced diet.

Bone pain in some women appears already in the early stages; it can have varying intensity and duration. In some cases, pain may persist throughout the entire period of pregnancy. This condition can be caused by calcium deficiency, high levels of the hormone relaxin, and the individual characteristics of a woman’s structure. In case of severe pain accompanying changes in the bones, you should limit climbing stairs, staying in a “sitting” position for a long time, and walking for a long time. It is not recommended to sit or lie on a rigid support. It is important to control your weight and wear a brace. When changing your body position in bed, you must first turn your shoulders and only then your pelvis. Calcium supplements may be prescribed to relieve severe pain.

Tip 2: What are the changes in digestion in pregnant women?

During pregnancy, a woman experiences various changes in her body. Changes in the functioning of the digestive organs of the expectant mother deserve special attention, since it is their proper functioning that helps provide the fetus with all the necessary substances.

Features of the functioning of the digestive system of the expectant mother

The entire digestive system, and in particular the liver, stomach, intestines and salivary glands, is aimed at performing an important function - removing harmful metabolic products from the body of a woman and her baby. For example, some electrolytes, ammonia and urea are released with gastric juice.

During the period of bearing a child, various abnormalities often occur in the digestive organs of the expectant mother. The absorption of foods becomes worse, and metabolic processes are disrupted. This is due to changes in the location of organs. Compression may occur, which has a detrimental effect on blood circulation.

Functioning of a pregnant woman's stomach

During the period of bearing a baby, the uterus enlarges, which over time begins to put pressure on the stomach. The result of this pressure is its displacement upward and backward. The ability of the stomach to retain food is reduced. In the third trimester, the acidity of gastric juice drops sharply. In some women, acidity, on the contrary, increases. This occurs due to frequent vomiting in expectant mothers.

The functioning of the intestines of a pregnant woman

The work of the expectant mother's intestines also undergoes changes, especially affecting the movement of food through the gastrointestinal tract. During the period of bearing a baby, intestinal motility decreases significantly, so a pregnant woman may experience constipation, exacerbation of hemorrhoids and other unpleasant sores.

Functioning of a pregnant woman's liver

The condition of a pregnant woman's liver also changes. In the last months of pregnancy, the expectant mother's liver enlarges significantly and becomes saturated with blood. Some pregnant women may experience increased cholesterol in the blood and disruption of the gallbladder. If a woman had chronic diseases before conceiving a child, for example, the liver or biliary tract, then during pregnancy they can worsen, and there is an increased risk of stone formation. The liver may change its location slightly, move up or to the right, and the bile ducts will dilate.

Many women during pregnancy say that their taste preferences change. While they are carrying the baby, expectant mothers want something special that they never wanted before pregnancy. In the mornings in the early stages of pregnancy, nausea and vomiting often occur; it will pass a little later, by the third or fourth month.

Why is pelvic size measured in pregnant women? What are the consequences of narrowing this part of the body?

Why is the pelvic area examined for pregnant women?

It so happened that the child moves along the birth canal through the pelvis. This part of the female body is finally formed before the age of 18. This detail distinguishes women from men. Most likely it is due to the fact that representatives of the fair sex bear and give birth to offspring. Incorrect size of the pelvis or pathologies of its development negatively affect childbirth, cause various complications, or even prevent the baby from getting out.

Normal sizes of the female pelvis

There are several parameters for measuring the female pelvis with their standards:

• DS (Distantia spinarum) - up to 26 cm.
• DC (Distantia cristarum) - up to 29.
• DT (Distantia trohanterica) - up to 32.
• GE (Conjgata externa) - outer part up to 21, inner up to 11 cm.

How is the pelvis measured during pregnancy?

At what stage of pregnancy is the diagnostic procedure performed?

Wide pelvis

Narrow pelvis, consequences

• Injuries to the baby.
• Hypoxia of the child inside the womb.
• Heavy bleeding.
• Torn ligaments or uterus.
• Placental abruption.
• Weak pushing and contractions.
• Premature discharge of amniotic fluid.

The influence of a narrow pelvis on the course of pregnancy and childbirth

• Displacement of internal organs.
• Preeclampsia.
• Umbilical cord entanglement.

A woman with a narrow pelvis is always at risk. Natural childbirth is possible provided that the head of the unborn baby is much smaller than the hole. Also, at the moment of the onset of labor, you need to ensure that parts of the baby’s body do not accidentally fall out.
The size of the pelvis matters; it was not without reason that in ancient times women with wide hips were chosen for procreation. However, at the present stage, with the right approach, it is possible to solve this problem in favor of a successful outcome of pregnancy and childbirth.

As a rule, physiology is a predisposing factor, but this does not reduce suffering and pain.

When the pelvis hurts, this is one of those signs that disappears after the birth of a child, but during pregnancy, any measures taken can only slightly reduce the discomfort; in this case, nothing helps. In addition, pain in the pelvis remains for about six months after pregnancy.

Causes of pain

As soon as a woman becomes pregnant, you need to realize that it is important for her body to get used to the new load. The biggest changes occur in the genital area. Thus, the uterus grows significantly over the course of 9 months along with the baby’s growth.

Discomfort in the form of pelvic pain during pregnancy develops at first. A predisposing factor is stretching of the uterine ligaments. The uterus is installed in the pelvis by many ligaments, the main ones pass along the side of the uterus, while this prevents it from deviating forward.

The uterine ligaments are made of connective tissue (all tendons and ligaments in the body are formed from the same tissue). Connective tissue has little ability to stretch; in the body it serves as a kind of “framework” that holds organs in place.

It is inherent in nature that the uterus will grow, and the connective tissue needs to stretch, not taking into account the fact that in other cases this is unusual for it. The hormone relaxin appears in the blood of a pregnant woman in large quantities. Thanks to this hormone, the extensibility of the above-mentioned tissues increases. Relaxin affects other ligaments, making leg pain common during pregnancy.

The pain of a sprain will continue to bother you throughout your pregnancy. The pain is acute, appears on the right or left side, disappears almost immediately if you change the position of the body. The uterus, however, remains soft and relaxed, which distinguishes such pain from the threat of miscarriage.

Manifestation of bone discrepancy

If the bones of the legs and spine are painful, this may indicate an increasing volume and weight of the pregnant woman and the fetus itself in particular. Therefore, increasing body weight needs to be controlled, which will help avoid severe stress on the musculoskeletal system. Pain in the pelvic bones can be the result of osteomalacia (vitamin D and calcium deficiency). In such a situation, taking multivitamin medications for pregnant women should be supplemented with calcium supplements. However, their prescription is controlled only by a doctor. It is important to remember that calcium is not prescribed to pregnant women at 34 weeks.

Quite rarely, pregnant women are diagnosed with obvious osteomalacia, that is, the woman no longer has the ability to move or has mechanical fractures. This conclusion serves as an indicator for stopping pregnancy.

A common occurrence during pregnancy is calcium deficiency. Therefore, for women, in almost all cases this is the only explanation for pelvic pain. However, you should not be sure of this, since when the pelvis hurts, it may be related to diseases of the musculoskeletal system, in particular if such pathologies have already existed before. Systemic lupus erythematosus, rheumatoid arthritis, dermatomyositis can be dangerous for the mother and her unborn baby, so you should not risk your health and the condition of the fetus if the pelvic bones are painful. It is extremely important to consult a doctor for advice on their nature and location.

Approximately 15-25% of women in labor suffer from pain in the pelvic bones, but you should not rely on the experience of former women in labor. Yes, a woman often suffers from illnesses, and she can only help herself by taking vitamins.

Expansion of bones occurs due to deformation of soft tissue structures. Over time, the ligaments in the pelvic joint area relax even more. As is normal, this condition is accompanied by mild pain in the pubic area. When the pelvis expands, the tailbone becomes mobile, which causes discomfort when sitting for a long time. Less severe pain affects women who, before bearing a child, were engaged in physical activity, maintained an active lifestyle and ate properly.

The duration of bone pain can vary from person to person. Sometimes they bother you throughout your pregnancy.

As a means of relieving pain, it can be:

• Limitation of climbing stairs.
• Long sitting position.
• Long walk.

When prevention is carried out before conception, this is the most correct decision. An active lifestyle, balanced nutrition, control of posture, exercise in the pool - all this is useful for the expectant mother.

If the problem becomes something unexpected, then you need to reduce physical activity.

Also, following these rules will help reduce the likelihood of risks:

• You should sit in a sitting position for no more than one hour.
• You should not take an asymmetrical position, as this will make the pain worse. The weight should be distributed equally on the legs; while sitting, you should not cross your legs. The chair should be comfortable, it should have adjustable armrests and a backrest.
• When sitting in a car for a long time, you should try to position your legs so that they are not higher than your pelvis.
• Food products should be fortified with calcium and vitamins.
• It is necessary to unload the hip joint. To do this, you need to put a couple of rolled blankets or pillows under your feet, and you need to place a pillow under your buttocks, while it is important to raise your pelvis. This will reduce fetal pressure on the pubis and lumbar region.
• It is better to exclude steps to the side. It's better to turn around and take steps back and forth.

In conclusion, it must be said that self-control, a healthy lifestyle and timely visits to the doctor eliminate many problems during pregnancy.

Pelvis during pregnancy

The pelvis of an adult woman consists of four bones: two pelvic (nameless), the sacrum and the coccyx, which are connected to each other by cartilage and ligaments. In turn, the pelvic bone was formed as a result of the fusion of the ilium, pubis and ischium, at the age of 16 - 18 years. The female pelvis, compared to the male one, is wider and more voluminous, but less deep. The presence of a normal pelvis is one of the main conditions for the normal course of labor. Various deviations in the structure of the pelvis and its symmetry can lead to a complicated pregnancy and complicate the normal passage of the child through the birth canal or completely prevent natural childbirth.

Measuring the pelvis during pregnancy

When registering a woman for pregnancy, as well as upon admission to the maternity hospital, the doctor conducts a detailed examination and measurement of the pelvis. Pay attention to the shape of the pelvis, the symmetry of the location of anatomical landmarks (anterosuperior and posterosuperior spines and iliac crests) and the sacral rhombus (Michaelis rhombus).

The Michaelis rhombus is a platform located on the posterior surface of the sacrum. The upper angle is located in the depression between the spinous process of the 5th lumbar vertebra and the beginning of the middle sacral crest, the lateral angles correspond to the posterosuperior iliac spines, and the lower angle corresponds to the apex of the sacrum. Normally, the rhombus is symmetrical, but with different variants of a narrow pelvis, its shape and the dimensions of the transverse and vertical diameters change.

To predict the nature of childbirth, the study of the size of the small pelvis is of greatest importance. However, most internal dimensions are not available for measurement, so external dimensions are usually measured and the size and shape of the small pelvis are judged from them. To get an idea of ​​the thickness of a woman’s bones, measure the circumference of the pregnant woman’s wrist joint with a centimeter tape (Solovyov index). On average, it is 14 cm; if the value is larger, then it can be assumed that the bones of the pelvis are more massive, and the size of its cavities is smaller than would be expected from the external measurement of the pelvis.

To measure the pelvis, a special tool is used - a pelvis meter. It has the shape of a compass with a scale on which centimeter and half-centimeter divisions are marked. During the measurement, the woman lies on a couch with her stomach exposed. There are usually four pelvic sizes measured:

• Distantiaspinarum - the distance between the anterosuperior iliac spines (the most prominent points on the anterior surface of the pelvis). Normally it is 25 – 26 cm.
• Distantiacristarum - the distance between the most distant points of the iliac crests, on average 28 - 29 cm.
• Distantiatrohanterica - the distance between the greater trochanters of the femurs, this size is 31 - 32 cm.

• Conjgata externa, external conjugate, direct size of the pelvis - the distance between the upper edge of the pubic joint and the upper angle of the sacral rhombus, is normally 20 21 cm. By the size of the external conjugate, one judges the size of the true conjugate, which characterizes the direct size of the plane of entry into the pelvis; normally it is 10–11 cm. With changes in this size, incorrect insertion of the head into the pelvic cavity may occur and, as a result, a complicated course of labor. The size of the true conjugate can also be determined during a vaginal examination of a woman by measuring the diagonal conjugate, but more often than not, with a normal pelvic size, the promontory of the sacrum is not reachable.

If during examination there are suspicions of a possible narrowing of the pelvic outlet, the doctor also measures the dimensions of this plane:

• Direct size is the distance between the middle of the lower edge of the pubic symphysis and the apex of the coccyx; 1.5 cm must be subtracted from the obtained value (approximate tissue thickness) and the resulting result is on average 9.5 cm.
• The transverse dimension is the distance between the ischial tuberosities; normally it is 11 cm.

With an oblique pelvis, oblique dimensions are measured and paired distances are compared to identify asymmetry.

Sometimes, to determine the true pelvic conjugate, the location of the fetal head, and the features of its insertion, ultrasound examination through the anterior abdominal wall is used. Transvaginal ultrasound allows you to measure the direct and transverse dimensions of the small pelvis.

According to strict indications, if it is necessary to obtain additional information about the condition of the pelvic bones, their joints, and the presence of deformities, an X-ray examination of the pelvis is performed.

During childbirth, in the process of moving through the birth canal, the child passes through four planes of the small pelvis. Based on the location of the sutures on the fetal head and the bony landmarks of the woman’s pelvis, the doctor determines their relative position, correct insertion and speed of advancement. This allows you to diagnose various disorders and change childbirth tactics in time. For example, if the size of the fetal head and the woman’s pelvis do not match (clinically narrow pelvis), it is not fixed in the plane of the entrance to the pelvis and contractions and attempts are not effective. And for a favorable outcome of childbirth for mother and child, a Caesarean section is necessary.

Wide pelvis

A wide pelvis is more common in tall, large women and is not a pathology. It is detected during routine examination and measurement of the pelvis. Its dimensions are 2–3 cm larger than the normal pelvis. Childbirth with a wide pelvis proceeds normally, but can be rapid. The time it takes for the baby to pass through the birth canal is reduced, and as a result, ruptures of the cervix, vagina and perineum may occur.

Narrow pelvis

In obstetrics, there are two concepts - anatomically and clinically narrow pelvis

Anatomically, a narrow pelvis is considered to be a pelvis in which all or at least one dimension is 1.5–2 cm below normal. But it happens that even with anatomical narrowing, labor proceeds normally, when the baby is small and its head passes through the mother’s pelvis without any complications.

A clinically narrow pelvis can be of normal size, but if the child is large, then there may be a discrepancy between the fetal head and the mother’s pelvis. In this case, vaginal delivery can lead to serious complications for the mother and fetus, so at the first sign of discrepancy, the possibility of surgery is considered.

Reasons for the development of a narrow pelvis:

• Rickets;
• Malnutrition in childhood;
• Cerebral palsy;
• Polio;
• Congenital anomalies of the pelvis;
• Pelvic fractures;
• Pelvic tumors;
• Spinal deformities (kyphosis, scoliosis, spondylolisthesis, coccyx deformity);
• Diseases and dislocation of the hip joints;
• Rapid growth during puberty with excess androgens;
• Significant psycho-emotional and physical stress during puberty.

Types of narrow pelvis:

• Relatively common forms

1. Transversely narrowed pelvis.
2. Flat pelvis:
3. Simple flat basin;
4. Flat-rachitic pelvis;
5. Pelvis with a decrease in the direct size of the wide part of the cavity.
6. Generally uniformly narrowed pelvis.

• Rare forms:

1. Oblique and oblique pelvis;
2. Pelvis narrowed by exostoses, bone tumors due to displaced fractures;
3. Other pelvic shapes.

Additionally, nowadays, erased forms of a narrow pelvis are more common, which presents significant difficulties in recognizing them.

Pregnant women with a narrowed pelvis are at high risk of developing complications and are specially registered at the antenatal clinic. Due to the narrowing of the size of the pelvis, the fetal head cannot be positioned correctly and therefore incorrect positions of the fetus are often found - transverse and oblique. Breech presentation occurs three times more often than in pregnant women with a normal pelvis. In women with a narrow pelvis in the last months of pregnancy, due to the high position of the uterine fundus, the heart is displaced and the movement of the lungs is limited, so their shortness of breath is more pronounced and lasts longer. 1 - 2 weeks before giving birth, the pregnant woman is sent to the maternity hospital to clarify the diagnosis and choose a rational method of delivery. With a narrowing of the pelvis of the first degree and a small size of the fetus and correct insertion, childbirth can proceed normally. However, most often there are some complications (incorrect insertion of the fetus, entanglement of the umbilical cord, fetal hypoxia, gestosis), and then a planned Caesarean section is prescribed.

During natural childbirth, a woman with a narrow pelvis should be under special control from the very beginning of labor. If the fetal head is not pressed to the entrance to the pelvis, and contractions have already begun, then there may be early rupture of amniotic fluid and prolapse of the umbilical cord, arms or legs of the fetus. The development of various anomalies of labor is also possible. In such a situation, they go for emergency surgery.

Pelvic pain during pregnancy

In the second half of pregnancy, women may experience pelvic pain of varying intensity and duration. The reasons are always different, so it is very important to tell your doctor exactly and in detail about your feelings.

As the size of the uterus increases, the ligaments that hold it in place begin to tighten, which can result in pain when walking and fetal movements. For prevention, it is recommended to wear a bandage. Under the influence of prolactin and relaxin, the ligaments and cartilage of the pelvis swell and soften to facilitate the passage of the fetus through the birth canal. In this regard, by the end of pregnancy, the pelvic circumference may increase by 1 - 1.5 cm, and after childbirth, when the hormonal levels return to their previous level, all these changes disappear. Excessive swelling of the pubic symphysis is very rare, which is manifested by bursting pain in the pubic area and the inability to raise a straight leg from a lying position - this is symphysitis. This condition can also be a complication of childbirth. Treatment depends on the extent of the discrepancy.

With varicose veins of the vagina and labia, there may be a feeling of heaviness of distension, which is caused by stagnation of blood. For any manifestations of varicose veins, it is necessary to wear compression stockings or bandage the legs with elastic bandages to prevent thromboembolic complications.

The pelvis has diverged by 8-9 centimeters, and after childbirth it will be the same as it was before pregnancy.

The question is: after childbirth, will the pelvis narrow back, as it was? And for how long?

Thanks in advance, everyone!

Girls, the pelvis does not separate. This is not a folding bike Aistenok. These are bones that do not transform, no matter how much we would like them to))

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AT WHAT TIME DO THE PELVIC BONES START TO SEPARATE?

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Do you feel pain? Maybe it's just a little bit of fat?

I didn't disagree at all. And my friend had it right before giving birth, about a week before.

"... Until the 16th century, it was believed that the pelvic bones diverge during childbirth, and the fetus is born, resting its legs on the bottom of the uterus. In 1543, the anatomist Vesalius proved that the pelvic bones are connected motionlessly.

"... The pelvis remains motionless during pregnancy, just remember anatomy at school. It’s just that in the front part of the pelvis there is a semi-joint - the pubic symphysis, with the help of which the pubic bones of the pelvis are connected. It has a cartilaginous structure and softens during pregnancy, due to which at the birth of a child It may diverge to the sides. But only at birth, and not during the entire pregnancy. The pubic symphysis is strengthened by two ligaments - the superior pubic and arcuate ligament of the pubis, and they hurt when walking or other stress.

How many days before birth do the pelvic bones begin to diverge during pregnancy?

When changes in a pregnant woman’s body go beyond physiological boundaries, pathological processes arise. The normal divergence of the pelvic bones during pregnancy is 5–6 mm. Exceeding this norm is called symphysiopathy. The condition is accompanied by severe pelvic pain, as well as the risk of excessive divergence of the pubic symphysis during childbirth. This is fraught for the expectant mother with a temporary or lifelong loss of the ability to move independently.

Causes of pain in the pelvic area

In the normal state, the pelvic bones are articulated with very dense cartilage tissue, which ensures the immobility of the pubic and iliosacral joints. During pregnancy, these connections are subject to ever-increasing pressure due to the baby's development and growth. In the second trimester of pregnancy, the production of the hormone relaxin is activated, which softens joint and tendon tissues, which provokes easier divergence of the pelvic bones within normal limits. This process is accompanied by natural symphysiopathy - a feeling of nagging or aching pain in the pelvis that does not increase over time.

Pelvic discrepancy is accompanied by natural symphysiopathy - a feeling of nagging or aching pain in the pelvis that does not increase over time.

If the condition of the joints of the pelvic bones is not normal, relaxin causes excessive softening of the symphysis. While carrying a child and increasing its weight, the abdominal muscles cannot overcome the lack of resistance from the joints and tendons, resulting in excessive divergence of the symphysis bones. It becomes mobile, and friction of the bones or disruption of the trophism of the joint tissue causes inflammation - symphysitis. Causes of symphysitis include:

• Disturbance of calcium-phosphorus metabolism.
• Lack of vitamin D.
• Osteoporosis.
• Chronic urogenital infections.
• Genetic predisposition.

Signs of development of symphysiopathy

The first symptoms of symphysiopathy appear at the end of the 2nd – beginning of the 3rd trimester of pregnancy. If the pelvic bones diverge to a normal distance during pregnancy, symptoms do not increase. They completely disappear with proper rest of the expectant mother.

The first symptoms of symphysiopathy appear at the end of the 2nd – beginning of the 3rd trimester of pregnancy.

Threatening symphysiopathy is manifested by pain that increases in proportion to the duration of pregnancy. As a rule, by the end of it, the expectant mother cannot stand or even sit. Signs of developing symphysitis are:

• Constant aching pain in the pelvis.
• Sharp pain in the pelvic bones when changing position.
• Swelling of the pubis.
• Pronounced pain on palpation.
• The appearance of a specific crunch or clicking in the pubis due to excessive bone mobility.
• Sharp pain when trying to roll over to the other side in a lying position.

Based on the pregnant woman’s complaints, the doctor may prescribe an ultrasound scan of the pubic joint to accurately determine the degree of divergence of the pelvic bones. With symphysiopathy of the 2nd degree, it ranges from 6 to 10 mm. If the pelvic bones of a pregnant woman are separated by a distance of more than 10 mm, the doctor can do without ultrasound, because his finger will fall into the resulting joint cavity. In this case, the doctor notes a divergence of the pelvic bones of the 3rd degree.

Treatment methods: is surgery necessary?

Physiological changes in the pubic symphysis are reversible - the pelvic bones fall into place within two months after the end of pregnancy. For grades 2 and 3 of symphysiopathy, the woman is prescribed medication, exercise therapy, and wearing a bandage. In case of severe divergence of the pelvic bones and weakening of the tendon apparatus, delivery by cesarean section is considered.

Drug treatment of symphysitis involves the prescription of the following drugs:

• Antibiotics.
• Anti-inflammatory drugs.
• Painkillers.

The use of drugs from these groups is extremely undesirable for pregnant women, therefore, the reason for prescribing them is only severe cases of symphysitis, when the benefits of the drugs for the health of the mother outweigh the potential risk to the child.

Based on laboratory tests of the pregnant woman’s urine and blood, the doctor determines the need to prescribe calcium and ergocalciferol supplements.

Based on laboratory tests of the pregnant woman’s urine and blood, the doctor determines the need to prescribe calcium and ergocalciferol supplements. Due to the risk of premature ossification of the fetal skeleton, doctors prescribe these drugs only for vitamin deficiency. In case of non-critical deficiency, they are limited to prescribing multivitamins for pregnant women.

At the first manifestations of symphysiopathy, doctors recommend taking full rest, but not limiting physical activity. The ideal option for sports exercises is exercise therapy, which is taught in courses for pregnant women.

If there is excessive divergence of the pelvic bones, the expectant mother is advised to:

• Stationary observation.
• Wearing a special bandage or tying sheets to the thighs.
• Limitation of physical activity.

This pathology is dangerous due to rupture of the pubic symphysis or divergence of the pelvic bones by 20 mm or more. In this case, the pregnant woman faces a recovery period of up to 8 months, as well as the risk of complete loss of the ability to move independently. For this reason, if there is severe discrepancy, a cesarean section is indicated.

A pregnant woman should report any signs of symphysiopathy to her doctor. Careful observation, as well as timely measures to prevent excessive divergence of the pelvic bones can preserve the health of the expectant mother.

Divergence of the pelvic bones during pregnancy symptoms

When do the pelvic bones begin to separate during pregnancy?

This question is often asked by expectant mothers in late pregnancy. The reason for this interest is the resulting pain in the pelvis. Are they harbingers of childbirth? When exactly do bones begin to separate and what should pregnant women know about this?

Why does the pelvic area hurt during pregnancy?

All pelvic organs of a pregnant woman in the third trimester experience pressure from the growing uterus. Therefore, the pelvic bones also hurt. But such pain can appear in a woman in the early stages. In this case, the cause is stretching of the round uterine ligaments. After all, the uterus is fixed in the pelvis by a complex of ligaments. They do not allow the main organ of the reproductive system to deviate forward. These ligaments are formed from connective tissue, and it stretches very poorly. But it is already laid down by nature that the uterus of the expectant mother increases, and the connective tissue must stretch. And a special hormone relaxin appears in a woman’s blood, which increases the extensibility of tissues.

And yet, stretching pain bothers a woman to one degree or another throughout pregnancy. Sometimes they can be very sharp, and disappear when changing body position. Most women already get used to such pain in the last weeks of bearing a child.

About the divergence of the pelvic bones

Note that during the weeks of pregnancy, changes in the pelvis are reflected in a woman’s gait. And this happens because the pelvic bones diverge. They become mobile. This is the gradual preparation of the female body for childbirth. When walking, a woman begins to lean her body back a little. It turns out that her tummy seems to protrude forward, and her gait becomes like that of a duck. It was during this period of gestation that expectant mothers still wore high-heeled shoes. they refuse it. After all, walking in heels becomes very uncomfortable.

The pelvic bones themselves do not change. But the amount of calcium in them may decrease. And this is due to the fact that calcium is intensively taken up by the developing baby. If the mother consumes few calcium-containing foods, then pelvic pain may be felt more strongly. The divergence of the pelvic bones when carrying a child occurs due to changes in the structures of soft tissues, that is, the symphysis - a dense cartilage that connects the pelvic bones in front. The mobility of the symphysis allows the baby's head to pass through the mother's birth canal.

It is the discrepancy of the bones that causes pain in the pubis and symphysis. If the female body experiences calcium deficiency, then symphysitis develops.

The expansion of the pelvic bones also affects the coccyx. The small bone with the sacrum has a low-moving joint. As a rule, it is deviated inside the pelvis. During delivery, the coccyx could interfere, for example, with dislocation, if not for the relaxation of the sacrococcygeal joint. In expectant mothers, this small bone deviates posteriorly. Therefore, it does not interfere with the progress of the baby through the birth canal. Pain caused by mobility of the coccyx immediately before childbirth intensifies in a sitting position, especially on a soft surface.

The divergence of the pelvis also affects the lumbosacral joint. Mobility increases in this area of ​​the musculoskeletal system. This happens already at the beginning of the third trimester. During the process of delivery, the pelvis and the spine form a single plane, and the above joint acquires greater mobility.

If a woman gives birth herself, without the help of obstetricians, then she intuitively takes those positions in which the child’s advancement is not difficult, that is, she squats, leaning forward, leaning on something. In the maternity hospital, special pillows (polsters) are placed under the buttocks of a woman in labor in order to straighten the axis of the birth canal. However, even before a woman gets to the maternity hospital, the mobility of the lumbosacral joint becomes a cause of pain. They are felt more by those women whose back muscles are weak. It’s not for nothing that they say that it is easier for athletes to give birth. Also, pain in the pelvis before childbirth can be felt strongly by those women who had problems with the spine before pregnancy: their pelvic bones diverge more heavily and more slowly.

After childbirth, pelvic pain disappears within two to six months.

Bones hurt during pregnancy. Pelvic bones during pregnancy. Pubic bone during pregnancy

Expecting a baby is the most desirable and exciting period in the life of every woman. While carrying a child, expectant mothers begin to take more responsibility for their health, listen to the body, and the signals it sends. Unusual pain, discomfort, changes in the body raise a lot of questions and make pregnant women anxious. Particular concern and concern among expectant mothers is pain in the bones during pregnancy: the bones of the pelvis, legs, and pubic bone. Why do bone pains occur and how to cope with painful sensations?

Why do bones hurt during pregnancy?

Very often you can hear complaints from pregnant women about pain in the bones of the pelvis, pubis and lower extremities. In most cases, pain and discomfort are observed late in pregnancy, being harbingers of impending birth. Pain in the bones and pelvis is caused by physiological changes associated with muscle strain due to a significant increase in the size of the uterus and fetus. The tummy grows quickly, and along with its growth, the load on the skeleton increases: the pelvis, spine, lower limbs. During this period, it is recommended to carefully monitor your weight and monitor your weight gain every month to avoid additional stress on the musculoskeletal system.

In addition, very often bones ache during pregnancy due to a disorder of phosphorus-calcium metabolism, in which a softening of the bone skeleton occurs in the body of the expectant mother. Also, pain and aches in the bones are affected by a lack of vitamin D. In this case, the expectant mother is prescribed complexes of vitamins and preparations containing calcium. It is worth noting that the drugs must be prescribed by a gynecologist, and calcium is not prescribed to pregnant women after 34 weeks.

At the end of pregnancy, a woman may suffer suffering and discomfort from pain in the pubis due to the divergence of the pubic symphysis - a process in which the pelvic bones rapidly diverge during pregnancy, preparing the exit of the fetus through the birth canal. The expectant mother feels pain in the middle of the pubis, and a change in gait may be observed, which resembles a “duck” gait, fatigue increases, and weakness in the legs and muscles is felt. During this period, it is important to undergo an ultrasound examination and consultation with a gynecologist.

Why do the pelvic bones hurt during pregnancy?

Pain in the pelvic region is considered a normal physiological symptom associated with bearing a child. Changes in hormonal levels during pregnancy lead to softening of the ligaments and muscles surrounding the pelvic bones. In this case, pregnant women feel pain not only in the pelvic area, but also in the womb, lower back, which radiates to the tailbone or perineum. The pain can be either moderate or very intense. However, do not forget that pain in the pelvic bones can also indicate serious diseases, such as the symphysis or kidney stones, so if pain occurs, do not neglect consulting a gynecologist. What are the causes of pelvic pain in pregnant women?

As the fetus grows, the load on the back muscles and pelvis increases, so in order to slightly reduce the load, you need to pay attention to posture, regularly wear a prenatal bandage and perform special exercises for expectant mothers that help strengthen and train muscles and ligaments. Exercises in the pool will be useful. It is not recommended to lift weights and try to reduce physical activity.

The expectant mother experiences pain in the pelvis and pubic bone. The pain especially intensifies and brings unbearable pain when walking up the stairs, with sudden movements, changes in gait occur, as the disease progresses, it is difficult for a woman to raise her legs from a lying position, she is physically unable to do this. If you observe this symptom, you should urgently consult a doctor, undergo an ultrasound and find out how much the space between the bones has diverged in order to determine the severity of the disease. Symphysitis causes a lot of inconvenience and torment for a woman, but the main danger for a pregnant woman suffering from symphysitis is a possible rupture of the symphysis during natural delivery. The consequence of a rupture is a long rehabilitation period, the inability to live a full life, since you will have to spend at least two weeks in bed rest and undergo a course of therapeutic exercises. A young mother will not have the opportunity to care for her baby. Therefore, it is so important to be under the supervision of a specialist during pregnancy, who can make a diagnosis in time and make a decision about a caesarean section.

Pelvic bones hurt during pregnancy in the first trimester

Sometimes pregnant women experience pain in their pelvic bones at the beginning of pregnancy. Such pain is intermittent and not intense, and does not cause discomfort. Under the influence of hormones, physiological changes occur in the body, leading to nagging pain in the pelvic area and above the womb. The discomfort is also caused by a lack of magnesium and calcium in the body. Early toxicosis, which is accompanied by nausea and severe vomiting, can lead to a deficiency of vital microelements. A woman may be bothered by heaviness in her legs, cramps occur at night, pain in the pelvic bones during pregnancy, and pain in the perineum. By replenishing the body with the microelements it lacks, painful sensations and pain are significantly reduced, and relief comes.

Why does the pubic bone hurt during pregnancy?

Pain in the pubic bone is usually observed shortly before childbirth. The body is intensively preparing for the upcoming event, the uterus with the fetus gradually descends into the pelvis. This natural process is associated with the appearance of severe pain in the perineum and pubic bone, as the load on them increases many times. If a pregnant woman experiences pain in the pubis and perineum before 37 weeks, this may indicate the possibility of premature birth. To relieve pain, it is recommended to wear a prenatal bandage that will support the lower back. Wear it starting from the 20th week of pregnancy. It is beneficial to do therapeutic exercises, swimming or yoga. This is a great way to reduce pain in the pelvic and pubic area.

Pain in the leg bones during pregnancy

In addition to pain in the pelvic bones and pubis, associated with hormonal and physiological changes occurring in the body, expectant mothers often experience pain in the bones of the lower extremities, especially in recent months. The following symptoms associated with pain and discomfort in the legs should be especially alert:

• feeling of severe pain that is constant in one or both legs. If the pain intensifies and does not go away for more than 3 days;
• the leg changes its appearance - turns blue, swells, becomes deformed;
• ulcers appear;
• In addition to pain in the legs, general health also worsens.

If one of these symptoms appears, you should urgently seek help. In other cases, pain, discomfort, heaviness in the bones of the lower extremities is a phenomenon that is observed in almost every expectant mother and is considered a normal physiological process.

The main reasons why bones in the legs hurt during pregnancy

1. Load on the legs due to an increase in the size of the uterus and fetus.
2. The hormone relaxin, produced by the body of a pregnant woman, helps soften ligaments and bones. The bones of the legs, feet, knees and pelvic bones may hurt.
3. Lack of calcium and vitamin D. Proper nutrition and taking the necessary medications can improve your well-being and relieve pain in your legs.
4. Spinal diseases that were observed before pregnancy (scoliosis, osteochondrosis), as well as bone diseases (arthritis, coxarthrosis, dermatomyositis).
5. Fractures and injuries received before pregnancy now remind of themselves. This pain is aching in nature, especially when weather conditions change.
6. The cause of pain and discomfort in the legs can be the asymmetrical position of the pelvic bones. It is recommended that the pregnant woman find a body position in which the pain will not be so intense.
7. Leg pain can be a consequence of flat feet, which can also begin to develop during pregnancy. The pain may be intermittent or it may be constant.

Why do the bones between my legs hurt during pregnancy?

At week 37, many pregnant women suffer from severe pain in the bones between the legs; this pain can appear for the following reasons:

1. Descent of the fetus into the pelvis. The fetal head puts pressure on the pelvic bones during pregnancy, causing discomfort in the bones between the legs.
2. The pelvic bones diverge during pregnancy. This process is accompanied by severe shooting pain in the legs and perineum.
3. Poor nutrition. Constipation can lead to painful sensations in the intestines, which radiate unpleasantly to the perineum.
4. Compression of the sciatic nerve by the fetus. If the sciatic nerve is compressed, it will be difficult for a pregnant woman to stand or lie in a certain position. As soon as the child takes a different position, the pain will subside.
5. Varicose veins in the perineal area. If varicose veins are observed in the perineal area, then the expectant mother will feel painful sensations radiating to the perineum.
6. Loosening of ligaments associated with the production of pregnancy hormones.

Prevention of bone pain in pregnant women

To relieve severe bone pain, pregnant women should follow several preventive recommendations that will help reduce the painful sensations occurring in the body:

• Take the vitamin complex prescribed by your doctor, be sure to follow the dosage and not exceed it.
• Keep your weight under control; excess body weight leads to additional stress on the skeletal bones.
• It is useful to take short daily walks in the fresh air. Do physical exercises or yoga. With the help of moderate physical activity, the muscles of the back, buttocks, thighs, and abdomen will be strengthened, and the pelvic floor ligaments will also stretch and become elastic.
• Particular attention should be paid to your diet. Pregnant women need to consume more foods rich in calcium, magnesium and vitamin D. It is useful to include more dairy and fermented milk products in your daily diet: cottage cheese, natural yoghurts, low-fat cheeses, as well as eggs, meat, fish, seafood , greens and nuts.
• It is not recommended to stay in one position or pose for a long time, especially sitting in one place for a long time, this applies to pregnant women, working in an office and having a sedentary job. Change your position more often, get up, take walks.
• To relieve stress on your back and pelvic area, wear a prenatal bandage.
• Pregnant women are not recommended to climb many steps or walk long distances.
• The surface where you sit or lie should be soft, not hard.
• When the body is asymmetrical, pain in the bones may intensify. Therefore, if you are standing, distribute your weight on both legs, and when sitting, do not cross one leg over the other. The chair where you sit should have a back, and even better, if it is adjustable so that you can take a comfortable position.
• To unload the pelvic area, when lying down, it is recommended to place bolsters and pillows under the legs and buttocks. This will lift your pelvis and relieve stress from your lower back, pelvis and pubis.
• Don't take long steps to the side.

Exercises during pregnancy to help relieve bone pain

By performing the exercises below, you can relieve bone pain, strengthen your back, gluteal muscles, ligaments and prepare your body for childbirth in advance.

1. "Cat". This is a great exercise to relax your back muscles. Get on all fours, relax. As you inhale, arch your back as high as possible, while lowering your head down - stay in this position for a few seconds. As you exhale, relax and lift your head up. Repeat the exercise several times.
2. Lie on your back with your feet close to your buttocks. Now spread your knees to the sides, making light springy movements. Repeat 5-6 times.
3. While lying down, bend your knees and lift your pelvis slightly up, slowly lowering it. Do 5-6 reps.

Expectant mothers need to be more attentive to their health. At the slightest change, severe pain, especially if it lasts a long time and does not go away, in the pelvis, perineum or pubic area, you should immediately tell your gynecologist to determine the cause of its occurrence in order to prevent dangerous situations for health.

Symphysitis: divergence of the symphysis pubis during childbirth, what is dangerous, how to treat, causes and prevention

Pregnancy is a special condition of a woman in which all organs and tissues undergo changes. The musculoskeletal system of the expectant mother is no exception. Very noticeable changes occur in the pelvic bones, which form a “channel” for the birth of a baby.

How does the female pelvis work?

The pelvis is a closed ring consisting of the pelvic bones, sacrum and coccyx. The pelvic bones, in turn, consist of the pubic, ischial and ilium bones. The female pelvis, in addition to supporting the internal organs, has a very important function: carrying the child during childbirth. In this regard, all ligaments and cartilages of the pelvis have a peculiarity: they “soften”. The pubic symphysis, where the cartilage is located, also becomes more mobile and soft under the influence of a special hormone - relaxin. This allows you to slightly adjust the size of the pelvis to the circumference of the baby's head.

What is symphysitis?

Literally, symphysitis during pregnancy is inflammation of the pubic symphysis. It doesn't happen very often. While waiting for a baby, it is more correct to use the term “symphysiopathy.”

• It means excessive softening of the cartilage, an increase in the distance between the bones by more than 0.5 cm.
• In a non-pregnant woman, the distance between the pubic bones is approximately 0.2 cm.
• With age, it may increase slightly (up to 0.6 cm), then gradually decrease.

If at the time of birth the pubic bones still diverge, sometimes with rupture of the symphysis, this is called symphysiolysis. Sometimes an inflammatory process begins at the point of their divergence. These are symphysites.

Symptoms of symphysitis during pregnancy

The process of excessive divergence of the symphysis pubis, and even more so inflammation of the symphysis, always reveals itself with the following symptoms:

• Shooting or pulling pain in the pubic area
• Increased pain with physical activity, especially when abducting the hip to the side
• Pain spreading to the back, thigh or abdomen
• Pain in the symphysis pubis upon palpation
• Pain during intercourse
• Change in gait (“duck walk”, “waddle”)
• Relief or disappearance of pain at rest
• Possible defecation problems

It must be remembered that mild pain in the pubis is the norm during pregnancy; this happens in 50% of women. Sprained ligaments and softening of the symphysis lead to some discomfort, especially in the last weeks before childbirth. In such cases, expectant mothers just need to be patient. Only the appearance of severe, unbearable pain, as well as loss of range of motion and sleep disturbance are considered symptoms of symphysitis during pregnancy.

Divergence of the pelvic bones during pregnancy

Sometimes a pregnant woman experiences unbearable pain in the pelvic area. What is she pointing to? Is it dangerous? Many expectant mothers are interested in this question. As a rule, the pelvis hurts in the third trimester because the uterus begins to grow and puts pressure on it. Some women experience discomfort early on. In this case, the round uterine ligaments are stretched. Due to fixation, the main organ does not deviate forward. In addition, tissue stretching may be a consequence of the effect of the hormone relaxin. Some women experience severe pain throughout pregnancy. Only when the expectant mother changes position do they disappear.

Description

After 20 weeks, due to changes in the pelvis, a woman has problems with gait. The pelvic bones in this case are movable. This is how a woman prepares for childbirth. While walking, a woman leans her body back, while her stomach protrudes forward. When a pregnant woman walks, she looks like a duck. Some expectant mothers continue to wear heels, but when the pelvic bones are stretched, they completely abandon uncomfortable shoes.

We note that the pelvic bones do not change, only there is gradually less calcium in them, and it is taken up by the developing fetus. If a pregnant woman does not eat foods with calcium, she suffers from unbearable pain in the pelvis.

After the structure of the symphysis changes, serious problems arise and discomfort is felt in the pubic area. The pelvic bones can also expand in the area of ​​the coccyx. Please note that if the sacrococcygeal joint were not relaxed, the tailbone could dislocate during childbirth. In pregnant women, the bone is slightly tilted back so that the baby can move along the birth canal.

Pain before childbirth begins to intensify in a sitting position. In addition, the pelvic bones also diverge in the lumbosacral region. Already in the last period of bearing a child, the pelvis and spine are a single plane. When a woman gives birth herself, she knows what position to take so that her baby quickly moves along the birth canal. Some women in labor squat, lean forward, and lean on something.

In the maternity hospital, a woman in labor is specially placed under the buttocks to straighten the axis of the birth canal. However, before giving birth, a woman has to suffer from severe pain. The most unpleasant sensations bother those who have weak back muscles. It is easiest for those who play sports to give birth.

Pain in the pelvic area before labor is felt by expectant mothers who have problems with the spine. Their bones come apart slowly and heavily. After childbirth, all unpleasant sensations completely disappear within six months.

Development of symphysiopathy

Most often, the pelvis diverges due to a lack of vitamin D, as well as subsequently disturbances in phosphorus and calcium metabolism. Everyone knows that calcium is the main component that is necessary for bones and teeth.

Vitamin D is essential for pregnant women. If there is not enough of it, problems arise with the absorption of calcium and phosphorus from the intestines. With a lack of calcium in the blood, intestinal and gastric pathologies, diabetes mellitus, kidney failure, and other serious diseases develop.

Gynecologists often talk about dysfunction of the symphysis pubis. There are three main periods:

• Before giving birth. Pelvic pain develops from insufficient or excessive mobility, and also when a woman abuses oral contraception and has previously suffered a pelvic or back injury. This condition is typical for those who are giving birth to their second or third baby.
• During childbirth, dysfunction is caused by post-term pregnancy and operative labor.
• Hip dysplasia can often occur after childbirth.

Symptoms

When bones diverge, in addition to pain, the following characteristic signs appear:

• Leg cramps at night.
• Teeth are destroyed.
• Muscles twitch.
• The woman gets tired quickly.
• Nails noticeably deteriorate.

When the symphysis is not greatly expanded, a fleeting pain occurs in the lower back and pelvic bones, indicating osteochondrosis and radiculitis. Sometimes unpleasant symptoms are caused by the threat of miscarriage, so you need to carefully monitor your well-being.

During the second and third periods, unbearable pain in the bones bothers me, especially when the pregnant woman walks a lot and stands for a long time.

Treatment methods

If the pelvic bones diverge, surgery is not performed. If the symptoms are not pronounced, you just need to give up some physical activity. In this case, it is necessary to wear a bandage. At the same time, it is better to sleep on an orthopedic mattress.

It is very important to take calcium when carrying a baby. To make it better absorbed, take B vitamins and fish oil. Additionally, ultraviolet irradiation is required - just a little time in the sun.

A pregnant woman must keep her pelvic bones in a special position; for this she must adhere to bed rest. Sometimes you need to wear a bandage and bandage the bones tightly.

On the first day after childbirth, cold is used, then the doctor prescribes physiotherapy, which will help restore the articulation of the womb. Your doctor may prescribe pain medications. If symphysitis occurs, you also need to take antibiotics.

To determine the effectiveness of treatment, an x-ray is performed, then the woman must wear the bandage for some time. Today, corsets are sold that help keep the pelvic bones in the required position. After a few days, the pregnant woman can slowly get out of bed and take care of the baby on her own. Despite this, you will have to give up physical activity for a while.

Thus, the separation of the pelvic bones is a physiological process, so there is no need to worry. If you are experiencing unbearable pain, you should consult a doctor. He will prescribe treatment and help alleviate the condition. Pay close attention to your health!

In the later stages of pregnancy, many women experience pain in the pelvic area. This is not a pathology. In this way, the body prepares for childbirth so that the baby can easily come into the world. The normal divergence of the pelvic bones during pregnancy is 5-6 mm; if this value exceeds the limit, then in this case the process is called symphysiopathy and can lead to negative consequences and even disability.

The birth canal through which the baby passes is formed by the pelvic bones and soft tissue. The ilium, pubis and ischium are connected in a ring at the back to the sacrum by means of ligaments, and in front is the symphysis (a formation of two pubic bones connected by a cartilaginous disc). In the middle there is a small articular cavity and fluid. There is a ligamentous apparatus around it that holds it in a certain position.

As the uterus grows during pregnancy, pressure begins to be exerted on them, which constantly increases. The mechanism of how the pelvic bones move apart during pregnancy is now well known.

In the second half of the term, relaxin begins to be intensively produced in the woman’s body (placenta and ovaries). It works on the ligaments and tendons so that the joint surfaces in the pelvis become more mobile. This is how natural symphysiopathy occurs, accompanied by dull pain in the pelvis. Usually they are tolerable and do not tend to grow.

If, against the background of physiological changes, there are a number of factors that change the condition of the symphysis of the pubis, then excessive discrepancy and inflammation (symphysitis) may occur.

The reasons are:

• weakness of the abdominal wall muscles, which cannot provide additional resistance from the joints;
• imbalance of calcium and phosphorus in the body of the expectant mother;
• lack of vitamin D and calcium;
• disturbance of mineral metabolism due to poor kidney function;
• osteoporosis;
• acute or chronic urogenital infection;
• features of the structure of bone and joint tissues, which are inherited.

It is important! A previous injury to the pelvic bones or a history of difficult childbirth can provoke a discrepancy.

How it manifests itself

When the pelvic bones begin to separate during the physiological process of preparation for childbirth, minor pain may occur. They do not increase over time and disappear completely after a night or day of rest in a horizontal position. This phenomenon occurs at the end of the second or beginning of the third trimester. Usually the doctor knows how long before birth the pelvic bones diverge, and conducts an examination, and, if necessary, prescribes a study.

The pathological condition of divergence of the symphysis is accompanied by an increase in pain as the pregnant woman’s uterus grows. They can be so strong that before giving birth a woman can only lie down, since sitting and standing aggravate the pain. The “frog” pose eases the pain a little, when the expectant mother sits with her knees spread apart and her arms turned outward.

Signs of deviation are also:

• sharp deterioration with any change of position;
• swelling in the pubic and suprapubic area;
• soreness of this area during palpation examination with irradiation into the vagina and anteriorly;
• discomfort during sexual intercourse;
• the appearance of a crunch due to increased mobility of the joint.

If symptoms are constantly increasing, then it is important to accurately determine the degree of discrepancy. To confirm the diagnosis, the specialist prescribes an ultrasound scan. During the study, the degree of deviation is set:

With 3 degrees of discrepancy, you can do without additional research. The doctor himself will determine the advanced pathology when his finger falls into the cavity of the enlarged joint during the examination.

Unpleasant sensations also occur in the woman in the area of ​​the coccygeal joint. A small bone, which is the tailbone, can prevent the baby from coming into the world and therefore begins to deviate back as the term increases. The pain worsens when sitting.

What is the danger

The pathology seems dangerous when there is a pronounced discrepancy. In the case when the distance between the bones is 20 mm or more, the pathological deviation ends with the need to undergo long-term rehabilitation for a period of more than 8 months.

If pain in the symphysis begins before the 37th week, then this symptom may indicate a high probability of premature birth. In this case, wearing a bandage helps, which experts recommend wearing from the 20th week, especially if the expectant mother experiences a change in the condition of her connective tissue.

The most severe consequence is rupture of the symphysis pubis during or after childbirth. This leads to disability and immobility of women. At the same time, bladder damage, bleeding and inflammation occur.

How to treat

If there is a physiological discrepancy, no action is required. All processes in this case are reversible and the bones return to their usual place two months after birth.

Sometimes, to speed up the process, it is suggested to wear a bandage and avoid physical activity. Some relief comes from sleeping on an orthopedic mattress to relieve the strain on your back.

The second or third degree of pathology requires drug correction, physical therapy and the use of a special bandage. The goal of all these measures is to try to bring the pelvic bones closer together and keep them in this position. If the discrepancy of the symphysis pubis is very large, then the child is removed in due time by cesarean section.

Medicines

Among the medications, the expectant mother should take antibacterial agents, anti-inflammatory drugs, and painkillers. But taking into account the fact that all medications in these groups have a number of extremely undesirable effects for the child, they should be used only as a last resort, exclusively as directed by a doctor.

After a routine analysis of urine and blood, calcium supplements are used in the presence of hypocalcemia. But in a pregnant woman, they are used only in case of severe deficiency, so that early ossification of the fetal skeleton does not occur. It is usually recommended to maintain normal levels with a multivitamin with the minimum required amount of microelements (potassium, calcium, magnesium).

Exercise therapy

If pain in the pelvis occurs, the doctor recommends that the woman limit physical activity and rest as much as possible. But at the same time, you cannot constantly spend time in a horizontal position. To strengthen the abdominal muscles and reduce the likelihood of pelvic bone divergence, you should perform the recommended set of exercises, which are selected by a physical therapy doctor on an individual basis.

Pain can be eliminated by several types of exercises:

1. "Cat" movement. Standing on all fours, while inhaling, you need to bend your back upward, while lowering your head. Stay in this position for a few seconds. As you inhale, relax and raise your head. Repeat the movement several times.
2. Lying on your back, bring your feet to your buttocks with your knees bent. Spread and bring your knees together several times with springy movements.
3. The position is the same as in the previous exercise. Perform a slight lift of the pelvis, repeating the movement several times.

The extreme severity of symphysiopathy requires inpatient observation, the use of a special bandage or tying a sheet at the level of the hips while sitting, standing and walking. It is also important to observe bed rest, which extends until 3-4 months after birth.

Prevention

The health of the expectant mother and the baby depends on her lifestyle; it is advisable to plan your pregnancy in advance and prepare for it. To reduce the likelihood of pelvic bone divergence, the following measures should be taken:

Conclusion

The prognosis for divergence of the pelvic bones during pregnancy, even in the case of symphysiopathy, is usually favorable. But only if a woman promptly complains to a doctor who knows exactly what to do if the pelvic bones have separated before or after childbirth. Therefore, if pain occurs in the symphysis or coccyx area, especially in the early stages, you should seek qualified help from a doctor.

In contact with

The size of the pelvis during pregnancy is measured during the first visits to the doctor’s office. Such parameters are studied in order to determine the future course of labor, as well as to diagnose possible asymmetry or abnormal structure.

General information about the structure of the pelvis

Normal natural delivery depends on the structure and size. Violation of symmetry, deviations and anomalies often lead to complications during pregnancy and childbirth. Measurements become especially important if the ultrasound reveals the baby’s presentation, then maximum care will be required on the part of doctors.

Normal pelvic sizes in obstetrics during pregnancy

First, doctors need to measure the Michaelis rhombus, or lumbosacral rhombus, which is assessed while standing at the back of the sacrum and should be symmetrical in shape. In normal condition, the vertical length is 11 cm and the width is 10 cm. Any deviations, non-standard shape and unclear diamond-shaped silhouette indicate the emergence of difficulties as pregnancy progresses.

• interosseous measurement of about 25-26 centimeters - determines the distance between the most protruding points of the bone in front;
• between the crests of the iliac bone tissues the distance should be 28-29 cm - this is the norm;
• the length between the greater trochanters of the 2 femurs is 30-32 centimeters.

Table of normal values ​​for pelvic size during pregnancy:

It should be remembered that the difference between the first three measurements is on average 3 cm; a decrease in this value suggests a significant narrowing of the pelvic bones.

The importance of a wide and narrow pelvis during pregnancy

A narrow pelvis is diagnosed when the parameters decrease from 1.5 cm. At the same time, in obstetrics there is the concept of anatomical narrowing, which is observed when the norm decreases to 2 cm. Diagnosing a narrowing does not necessarily indicate a pathologically difficult birth. Often women with narrow parameters give birth to a small baby, and the head passes without difficulty. The indicator is measured to assess risks; if a large fetus develops inside the womb, this often leads to serious consequences during the process of natural spontaneous childbirth.

Narrow pelvis - risk factors for pregnant women

According to statistics, pregnant women with narrow hips are much more likely to be diagnosed with fetal presentation. Therefore, they belong to a group that requires careful monitoring by medical specialists in order to reduce the likelihood of complications during the birth of the baby. It is not uncommon to observe early rupture of amniotic fluid, hypoxia and prolapse of some parts (umbilical cord, arms, legs) during pushing.

Post-term pregnancy is considered the most dangerous if narrow hips are diagnosed. Often, doctors decide to perform a planned caesarean section in order to minimize the risk of severe injury.