Ultrasonographic diagnosis of pubic symphysis diastasis at week 38 of pregnancy: A case report and literature review

Pubic symphysis diastasis (PSD) is a rare clinical postpartum disease among women that is mostly caused by parturition and diagnosed using radiography. Herein, we report a case of PSD diagnosed using ultrasonography during pregnancy and provide a literature review on pubic symphysis (PS). At 34 weeks' gestation, a 30-year-old patient (gravida 0, para 0) complained of pain in the bilateral thigh root and pubic region after 2 hours of walking. Turning over and walking aggravated the pain. Ultrasonographic examination at 38 weeks' gestation revealed PS (width>10 mm), uneven left pubic surface, and effusion in the space above the PS. PSD was diagnosed. Four follow-up visits at one year postpartum indicated that the pain occurred after walking for prolonged periods. Follow-up ultrasonographic examinations revealed a persistent left pubic ramus fracture. Computed tomography and magnetic resonance imaging (MRI) at five months postpartum showed a left pubic ramus fracture, pubic osteitis, and left hyaline cartilage surface and pubic ligament injury. This is the first report on PSD detected by ultrasonography during pregnancy that included relatively complete perinatal follow-up imaging information. Ultrasonography could be performed as the first necessary auxiliary examination for perinatal PSD. Performing MRI as well will help detect any complications.