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Re: pain from symphysis pubisFrom: Brian Hackman (brianhackman@easynet.co.uk)Thu Jul 18 01:57:16 1996
I should be grateful for some help with the following problem. A twenty-five-year old gravida 4 para 3 with treated thyrotoxicosis, had been on prolonged steroids which were stopped before she became pregnant. She is now at 26 weeks, with separation of the pubic symphysis, and in crippling pain so that she has to lie still all the time, and even then it continues to ache. The usual supportive measures have failed to help at all (they never seem to do any good). The available analgesics are not strong enough, and I am reluctant to put her on an addictive drug at such an early gestation. I asked one of our local orthopaedic surgeons if he had any bright ideas (an impossible combination?) and whether he would consider fixation with screws, wires or a plate-but he refused as all the others have done before him. Have any of you suggestions for management, and do you know if surgery has ever been tried for this condition antepartum or postpartum and if so what are the short term and long term results? Please.
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Brian Hackman
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