Spaeth D. Observatory clues to aid in the diagnosing of diastasis symphysis pubis: an underreported complication of parturition. J Am Osteopath Assoc 1997;97(3):152. doi: 10.7556/jaoa.19126.96.36.199.
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Diagnosis of diastasis symphysis pubis in the postpartum period need not depend on radiographic findings. This diagnosis can be made with simple observation techniques. Entertaining a high index of suspicion and observation of the patient are the most important contributions the physician can make. Parameters triggering a tentative diagnosis would include, but not be limited to, a large infant, a small pelvis, a rapid second stage of delivery, or application of forces to abduct the thighs. The diagnosis of diastasis symphysis pubis should be ruled out if the following conditions are present postpartum: the flattened abdomen (the postpartum "pooch" is absent); the patient is incontinent of urine when changing position from supine/prone to upright; the patient has pain in the hips or sacral region when walking; or the patient waddles when walking. The change in gait, or the pain on walking may not be noticed until 24 hours or more after delivery. However, the change in abdominal contour and incontinence is noticed immediately. Using these observational clues, the physician can institute treatment sooner, thereby expediting recovery.
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