Patient's question:
The patient is 25 years old and gave birth to a female live infant on March 15, 2012, receiving intramuscular oxytocin. The infant weighed 7.8 pounds. Forceful delivery resulted in a 5 cm separation of the pubic symphysis. After discharge, the pain worsened, and the patient was unable to walk, sit up, or turn over in bed. Currently, at 2 months, the patient experiences pain in the pubic area when turning or sleeping sideways. There is also pain in the sacroiliac joint, where the patient can roll over and lie on their side but cannot bear weight when standing. The pubic symphysis has healed to 1.89 cm, but the sacroiliac joint remains dislocated. How should this be treated?Doctor's answer:
Giant babies (greater than 4 kg) often lead to damage of the bony birth canal during natural delivery, particularly involving the separation and displacement of the pubic symphysis and the subluxation of the sacroiliac joint. Additionally, the hormones secreted during pregnancy, such as progesterone, relax the ligaments around the joints, making them more prone to dislocation and subluxation. For you, rest and pelvic belt fixation are necessary. Further treatment is recommended through conservative methods such as manual reduction, appropriate massage, relative immobilization, and exercises for the waist and back muscles, which also require time for recovery. Surgical intervention should only be considered if the symptoms recur and become severe. It is advised to visit a regular hospital for an accurate physical examination and reasonable tests to obtain the correct diagnosis and treatment.