Postpartum Osteitis Pubis Following Spontaneous Vaginal Delivery: A Rare Cause of Pubalgia

Abstract

Introduction: Osteitis pubis has been known as a noninfectious inflammation of the pubis symphysis. It is poorly understood and is rarely seen in the immediate postpartum period following spontaneous delivery. Case report: A 25 year old primigravida had a spontaneous delivery at 37 weeks of gestation. 5 days following the delivery she complained of dull aching pain the in lower abdominal and pubic region. Pain was continuous and increased on activity and subsided on rest. Pain increased in severity and the she consulted local doctors who treated her with analgesics and antibiotics. The Pain did not subside and she presented to us a week following the onset of symptoms. A plain radiography of the pelvis was done which showed irregular bony lesion at the level of pubic symphysis. MRI scan of the pelvis was done and Osteitis pubis was diagnosed. She was managed with bed rest, anti inflammatory and physiotherapy. Pain subsided over a period of ten days and patient was discharged subsequently. She is engaging in all her activities of daily living with no complaints presently. Discussion: Osteitis Pubis is a rapidly progressive, nonsuppurative osteonecrosis of the symphysis pubis is frequently confused with other entities. Because the prognosis for recovery is invariably good, acute intervention is directed at relieving pain by immobility and anti-inflammatory agents. We present a rarely described case of osteitis pubis occurring in the postpartum period following spontaneous delivery.