dijastaza simfize

[simfiza]

Prije 3,5 godine sam prvi put rodila i došlo je do dijastaze simfize, tj. pubična simfiza (spoj zdjelične kosti) se razdvojio. Mjesec dana sam bila nepokretna, zatim teško ustajanje i hodanje uz pomoć štaka i sve skupa 6 mjeseci oporavka. To je bilo više nego grozno, ali neću puno kukati jer mi je moj dječak živ i zdrav, bez ikakvih oštećenja, a moglo je biti svašta. Sad sam opet trudna, 7. mjesec i opet problem, već neko vrijeme teško hodam, dosta bolova u predjelu simfize, a i cijele zdjelične kosti, uz to vrlo nisko nosim i sad sam na mirovanju. Slijedeći porod je carski rez.
Ovaj problem je rijedak, ali se događa. Ni ja nisam nikad čula za to dok se nije meni dogodilo. Naši doktori nemaju nikakvog interesa za ovakve stvari, a mogu se usuditi i reći niti znanja. To je totalno frustrirajuće jer se nemate kome obratiti niti s kim posavjetovati. Njima je samo bitno da su majka i dijete živi, a sve ostalo nije bitno. Ja sam se naravno informirala i sad znam da se to može i izbjeći ako se vodi računa o trudnici. U mom slučaju su koraci napravljeni pogrešno (inducirani porod, ležanje na leđima za vrijeme poroda i izgona, pritiskanje trbuha itd)
Ima li još netko sa ovakvim problemom? Voljela bih čuti i tuđa iskustva i mišljenja.

[Sonja84]

Meni se isto to desilo. Porodila sam se prije 11 mjeseci i doslo je do dijastaze simfize. Mene je poslije 3 mjeseca prestalo boljeti i sada me je opet pocelo da boli, pa sam zabrinuta. Jesi li ti isla na vjezbe poslije poroda? Svaka ti cast pa si se opet usudila ostati trudna Nadam se da ce sa trudnocom i bebacem sve biti ok.

[MarijaP]

sad znam da se to može i izbjeći ako se vodi računa o trudnici. U mom slučaju su koraci napravljeni pogrešno (inducirani porod, ležanje na leđima za vrijeme poroda i izgona, pritiskanje trbuha itd)

Možeš li navesti svoja saznanja o tome kako to izbjeći? Potpuno prirodan porod, elektivni carski?

Žao mi je zbog svega što si prošla!

[rankica]

da sam bar ranije cula o tome prije nego sam iskusila na svojoj kozi,evo rodila sam krajem dvanaestog mjeseca 2010, ista stvar mjesec dana lezanja, nesposobna brinut se o sebi i maleckoj 20 dana u bolnici, evo sad sam se pocela dizat i sve me boli, moglo je proc gore, ali kad znas da se i sve moglo izbjec na to nesmjem mislit nadam se da cu na proljece moc van!

[srecica]

Evo nesto sto sam pronasla na ovu temu
http://www.plus-size-pregnancy.org/pubicpain.htm

Planning for Birth
Certain common obstetric interventions tend to make Symphysis Pubic Dysfunction pain worse, and may even lead to ligament damage or severe separation of the joint, causing true Diastasis Symphysis Pubis. Therefore, it is vitally important that your doctor or midwife understand and believe in the existence of SPD and realize its implications for birth. The following ideas (taken from a number of sources) are supposed to help maximize your comfort and help the normal birth process, while also minimizing the risk for pubic symphysis-related trauma.

1. Be extremely careful of birth positioning. Certain positions are better than others. Avoid stirrups!
2. Be sure your labor assistants and providers know all about SPD, what movements can hurt or damage you, and what your comfortable range of motion is
3. Avoid most common labor interventions, as these often cause pubic symphysis strain/damage
4. Avoid an epidural if at all possible, as this often is associated with more severe damage
5. Use a 'narrow gap' between the legs for any routine procedures that can't be avoided
6. Hire a birth attendant that is familiar with and can help resolve baby malpositions

Specifically, you might want to consider the following:
1. Be extremely careful of birth positioning. Certain positions are better than others. Avoid stirrups!

• Don't give birth on your back - Many cases of pubic symphysis injury occur in this position
• Don't give birth semi-sitting - This tends to force the baby's head against the pubic symphysis, putting pressure on it to 'give' more. It also prevents the coccyx/tailbone and sacrum from moving out of the way during birth, and thus the only joint available with any 'give' to it would be the pubic symphysis, which puts it at greater risk for damage
• Don't use stirrups - This widens the gap between the legs and strains the pubic symphysis
• Use 'alternative' birth positions - These include standing, kneeling, and all fours in particular. You may have to search for a provider that is comfortable using these positions throughout labor. Some doctors will 'permit' women to use alternative positions until just before baby's head crowns, but often want the woman back in the traditional stirrups or semi-sitting position for crowning of the head and delivery of the shoulders. However, crowning and birth of the shoulders is the most critical time for prevent pubic symphysis damage, so really look for a doctor or midwife that is willing to 'let' a woman be in whatever position feels best to her for birth. If you must be in a more 'traditional' position because of other concerns, try side-lying as this takes the pressure off of the pubic symphysis and allows the coccyx and sacrum to move somewhat. Otherwise, all-fours or leaning back over a birth ball may be best
• Listen to your body - Your body usually will tell you what position you need to take in order to help baby out while avoiding damage to your joint. This may be contrary to what your nurses or provider are telling you, but give preference to the positions that feel best to you. For example, sitting forward in a "C" is the position promoted in most hospitals, but Kmom found arching the back to be most helpful. This helped her baby move under the pubic arch and be born rapidly, while in the traditional "C" semi-sitting position, there was no descent of the baby and great pain instead. Other women with pubic pain have reported that arching the back during pushing was helpful too. Use the position your body tells you to!

2. Be sure your labor assistants and providers know all about SPD, what movements can hurt or damage you, and what your comfortable range of motion is

• Hire a birth attendant that takes SPD seriously - Many providers do not really believe that SPD really exists or that it is a serious concern for birth. Little mainstream literature exists on it, so you may have trouble convincing some providers that it is anything more than the normal aches and pains of pregnancy. If they do not really understand the concerns of SPD, they will not be as careful at the birth
• Hire a birth attendant that rarely uses interventions like stirrups, forceps, etc. - If these interventions are not part of your caregiver's normal procedures, chances are good that you'll avoid them. If your provider often uses these procedures, chances are they will have a hard time avoiding them, even when they know that they need to be avoided
• Consider giving birth in a non-hospital facility or at home - This might help lessen chances of damaging interventions, since stirrups, forceps, and other routine interventions are done less in these settings
• Educate your birth attendant, coaches, and other helpers about SPD - Raise the awareness of SPD problems with your attendants and helpers so they can help you avoid problems during the birth. Be sure to especially discuss with them the importance of a 'narrow gap', avoiding interventions whenever possible, and how to avoid placing extra strain on the pubic symphysis area

3. Avoid most common labor interventions, as these often cause pubic symphysis strain/damage

• Avoid the use of forceps or vacuum extractor - These may necessitate opening the legs wider than the pubic symphysis can safely tolerate
• Don't pull your knees back too far - This puts a great deal of strain on the pubic symphysis joint. Be sure to let your nurses, doula, or labor coach know not to do this!
• Don't put your legs on your attendant's hips - Again, this strains the pubic symphysis joint
• Minimize or avoid vaginal exams - Positions for vaginal exams tends to strain the pubic symphysis joint. Do as few vaginal exams as possible (most are not necessary anyhow) so there is less frequent strain, and use as small a leg gap as possible if a vaginal exam must be done
• Avoid an induction if possible - Induction contractions are often abnormally strong and difficult to handle without an epidural to help, and this increases your chances of other harmful interventions
• Avoid breaking the waters early - Since malpositions may be more common with SPD, it is probably sensible to avoid breaking the waters artificially during labor. If baby is malpositioned and the waters are broken, then baby often moves down in that malposition, cannot turn, and gets 'stuck', necessitating a c-section. If labor stalls around 4-7 cm or so in a woman with SPD, then baby malposition should be suspected, breaking the waters avoided, and changing maternal posture utilized to help baby turn

4. Avoid an epidural if at all possible, as this often is associated with more severe damage

• Avoid an epidural so you can tell if damage is imminent - Once your feelings are deadened, you may not be able to tell if they force your legs too strongly, and this is when many tears or severe separations occur
• Avoid an epidural to lower the chances for forceps, vacuum extractor, and stirrups - Stirrups are standard procedure in many hospitals with epidurals, and stirrups increase the chances of damage. In addition, one side-effect of epidurals is to strongly increase your chances of needing forceps or vacuum extractor during pushing, which also necessitate a wider leg position and increase the chance for pubic symphysis damage
• Consider hiring a doula (professional labor support) - A doula can often help you cope with labor without having to have an epidural; she can also help you remember to remind caregivers to avoid a wide gap. Research shows that need for epidurals and other pain relief methods is much lower with a doula present

5. Use a 'narrow gap' position between the legs for any routine procedures that can't be avoided

• Use a string to measure ahead of time the widest comfortable position for your legs - Have your coaches use that in labor to remind nurses and other attendants of the widest position that is wise
• Use a 'narrow gap' only - If vaginal exams is truly necessary or if any stitching is needed afterwards, be sure to remind the providers to use a 'narrow gap' only

6. Hire a birth attendant that is familiar with and can help resolve baby malpositions

• Research and understand the signs of a baby malposition - Baby malpositions may be more common in women with misaligned pelvises and pubic pain, and this can cause a more painful, difficult labor. Understanding the issues and knowing the symptoms may be very important in avoiding such a labor
• Understand how to prevent malposition or turn a malposition during labor - There are things that can be done to help avoid a malpositioned baby or even to help turn one during labor. Educate yourself more about this so that you can be proactive about prevention at home and pass on the info to your provider
• Hire a birth attendant that takes malpositions seriously and knows how to help them - Most doctors and many midwives do not really understand baby malpositions and how they can affect labor and birth. It would probably be very helpful to hire a birth attendant that pays careful attention to baby's position before and during birth, and knows how to use maternal positioning and other techniques to get a baby to turn. [For more information on this subject, read the FAQ on Malpositions on this website.]

Please note that when the pelvis is well-aligned and labor precautions are taken, most women are able to give birth vaginally without any problems or damage. An elective cesarean is NOT necessary for women with SPD; if precautions are carefully observed, the chances of pubic symphysis damage are greatly lowered and the significant risks associated with cesareans are avoided as well.
However, because the pressure on the pelvic joints to expand is greatest as baby emerges, women with SPD may find that pushing is uncomfortable at times. If they are allowed to use the position that feels best to them and if birth attendant pays attention to the baby's position, baby is usually born without difficulty and this discomfort is minimized and transient, unlike the post-surgical pain that would be associated with a cesarean. Being aware that pushing may be uncomfortable and knowing the importance of using alternative birthing positions (try arching your back!) may go a long way towards helping a woman be prepared for and deal with this.
In Kmom's opinion, the most sensible approach to SPD is probably to carefully correct any pelvic or spinal misalignment during pregnancy and well before labor. However, because of the hormonal influences on the pubic symphysis area, it is probably also extremely important to utilize these labor precautions as well. Women with SPD can give birth safely vaginally, and this is usually best for both mother and baby. However, being proactive about positioning and avoiding interventions during labor is only sensible as well.

[Anvi]

Na ovoj temi smo već pisali o dijastazi simfize, ili simfiziolizi, i općenito o bolovima u području simfize i kako ih izbjeći ili olakšati.
http://forum.roda.hr/threads/27941-b...u-stidne-kosti

Meni se simfizioliza dogodila nakon drugog poroda. Bolovi su bili neopisivi, nisam mogla mrdnut ni lijevo ni desno, ležala sam na leđima ko klada i jaukala, jer za razliku od trudova ta bol ne prolazi, prisutna je stalno, 24 sata na dan. A inače sam tip koji jaaako dobro podnosi bol i imam vrlo visok prag boli. Bila sam potpuno nesposobna brinuti se o djetetu, prvih mjesec dana sve oko bebe su radili MM i moja mama. Jedino bi mi je donijeli na dojenje, i tada bi me okretali na bok a meni su suze tekle koliko me to okretanje boljelo. Mislim da si to stanje i taj intenzitet boli može predočit samo netko tko ga je iskusio na vlastitoj koži, inače ga ne bi doktori tako olako uzimali i pripisivali normalnoj fiziologiji trudnoće.
Znakove koji se jave potkraj trudnoće (bol u zdjelici, u pubičnoj kosti, po simfizi) treba uzeti vrlo ozbiljno i izbjegavati kretnje koje opterećuju simfizu: ne čučati, ne klečati, ne hodati po stepenicama, ne razdvajati koljena pri ustajanju i lijeganju u krevet ili pri sjedanju u auto, itd. I ne rađati u (polu)ležećem položaju kao što se rađa u našim rodilištima. Takav je položaj kontraindiciran ako postoji šansa za simfiziolizu, a pogotovo ako se dogodila kod prijašnjeg poroda.
Položaj za rađanje koji ne opterećuje simfizu, dapače indiciran je za žene kod kojih postoji povećan rizik od simfiziolize, je četvernožni položaj. Na žalost, u našim je rodilištima izgleda lakše ženu poslati na carski rez nego joj ponuditi takav položaj za rađanje. Još jedan dokaz da obstetričari malo znaju o ovom problemu. Simfiza, ako čitaš ovu temu, pls javi kako si rodila i kako je prošao porod, te je li ti se i ovaj puta razdvojila simfiza. Iskreno se nadam da je sve bilo u redu.

Rankice, brzi i potpuni oporavak ti želim
Mene je bolilo još mjesecima nakon poroda, ali bila sam dosta dobro pokretna. Otprilike tek nakon godinu dana sam mogla potrčati bez da me išta boljelo. Iako će skoro biti 4 godine od moje simfiziolize, još me ponekad zna zaboliti kod određenih pokreta, no naučila sam se s time živjeti pa jednostavno izbjegavam položaje koji napinju simfizu.

[Ninjago]

Pozdrav svima nova sam na forumu ,imam nazalost iskustva sa dijastazom simfize.Rodila sam 2006 deckica teskog skoro 4 kg uz drip,naljeganje na trbuh .Dan nakon poroda javili su se grozni bolovi koji su trajali 6 mjeseci nakon poroda,sa bebom je bilo sve ok.Prije 3 mj.sam rodila curicu isto prirodnim putem za pola sata,sve ok sasimfizom a bojala sam se da cu opet zavrsit sa dijastazom jer su mi rekli doktori da nece radit carski jer dijastaza u prvom porodu nije indikacija za carski.