POSTPARTUM (POST-ABORTION) INFECTIOUS DISEASES : SIMFATIC (SYMPHYSITIS) - etiology, pathogenesis, symptoms and course of, recognition, prediction and prevention
The divergence of the symphysis pubis as a result of birth trauma, edema and hematoma in this area with subsequent inflammation, mostly not of bacterial origin. In rare cases, inflammation develops as a result of penetration of pathogenic microbes, even less - as metastasis septic infection.
From 2 to 3 - day postpartum period moderate pain in the pubic symphysis, aggravated by palpation. Symptom crunch (Apokyn) occurs when compression of the pelvis jerky movements, auscultated with a stethoscope; symptom Gurvich - pain in the lower back and thighs while lifting one, rarely both hands; radiographically: early in the disease the contours of the joint lubricated slit, the slit becomes wider; later the edges of the bones become jagged, hotspots dilution. The same x-ray pattern observed in young pervoverhovnyh to 25 years.
The swelling of tissues in the joints, and sometimes pain in the sacrum. Temperatures mostly above 38º.
Complications. Early ambulation is impaired gait.
A thorough study of the birth stories. X-ray examination. Having described the clinical picture and radiographic data to make a reliable diagnosis.
The prediction is good.
Rational management of childbirth.
Tight bandaging of the pelvis (best wide towels). Ice pack on the pubic symphysis. Long stay on a hard bed. Autohemotherapy 10 ml every third day. With increasing temperature, sulfonamide 1.0, three times a day, several days. When dysuric phenomena methenamine 0.5 ml three times a day. You can walk to resolve the disappearance of all clinical symptoms. In the formation of an ulcer - surgery or introduction into the cavity of his (daily) 50 000 units of penicillin with preliminary aspiration of pus and simultaneous intramuscular injection of him in the usual way.