Labor-Related Sacral and Pubic Fractures

Abstract

T he pelvic joints undergo changes during pregnancy and delivery that are due to hormonal influences and mechanical stresses, and low-back pain is a common symptom during pregnancy and post partum, usually because of mechanical lesions of the pelvic soft-tissues1. However, stress fractures of the lumbar spine or sacroiliac joint are rare complications. We report the case of a woman without pregnancy-related osteoporosis who had a stress fracture of the sacrum and pubis after delivery. The patient was informed that data concerning the case would be submitted for publication. Fig. 1 T1-weighted spin-echo (left) and T2-weighted STIR (short tau inversion recovery) (right) magnetic resonance images show a vertical almost-complete fracture through the upper part of the left sacral wing (arrow on the left image). Note the extensive edema adjacent to the lesion (arrow on the right image). A thirty-one-year-old woman sought medical advice because of three weeks of pain in the left buttock. The pain started five days after her first vaginal delivery. The pain was relieved with a self-prescribed treatment of ibuprofen and remitted soon without medication. She had a history of two episodes of low-back pain two years previously. Imaging studies did not show any underlying lesion. During the pregnancy, she gained 15 kg (1.6 kg in the last week), without complications except for one lower urinary tract infection that resolved with antibiotic treatment. The patient did not experience pelvic …