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Sunday, 29 July, 2001, 06:09 GMT 07:09 UK
'As I gave birth, I felt my pelvis split'
Researchers are focusing on the pubic symphysis
Researchers are focusing on the pubic symphysis
Although many women suffer pelvic pain while they are pregnant, some continue to suffer for the rest of their lives.

Doctors looking into the issue believe an unstable pelvis, which moves abnormally, could play a part in the condition.

The team from St Thomas's Hospital in London hope to find a way of identifying the women at risk early.

BBC News Online looks at their work, and hears one woman's horrifying story.

Janis Sinden says she actually felt her pelvis separate when she gave birth to her 11lb baby Grace.

During her pregnancy, she had told her GP she felt a worrying "movement" sensation - but she carried the baby to full term.

Janis Sinden: Says life has been turned 'upside down'
Janis Sinden: Says life has been turned 'upside down'
She was discharged from hospital just a day after the birth, despite finding it almost impossible to walk, stand up, or hold her daughter.

Five years later, she is still suffering, and says the condition is responsible for the break-up of her marriage.

She is also virtually housebound and relies on painkillers, rest and her parents to manage.

Janis, who also has an eight-year-old son, is now taking part in a 100,000 research project, funded by the charity Action Research, which is now underway at St Thomas's Hospital in London.

Diagnosis problems

The scientists leading the research believe the key to chronic skeletal pelvic pain could be the instability of the pelvis - but it is often not diagnosed.

It is believed the 300 women who suffer pelvic dysfunction every year could be helped if their condition could be picked up earlier.

Having a baby causes some women long-term pelvic pain
Having a baby causes some women long-term pelvic pain
Some women may be affected by the condition, but have no symptoms.

The doctors want to find out how common pelvic pain is, and whether surgery - in which a plate is inserted and bone grafted across the joint - could be the answer.

However doctors cannot guarantee surgery will improve women's condition - and it could even cause further complications.

Most cases are currently treated with a combination of bed rest, anti inflammatory drugs and physiotherapy.

'Early recognition may help'

Mr Rami Hussein, a trauma and orthopaedics, is part of the research team.

He said: "It may be that early recognition and treatment can help prevent women becoming temporarily or permanently disabled, but the condition is a complex one."

He added that the condition was very difficult to treat because every woman's experience of giving birth differed , so finding an exact cause of pelvic pain would be difficult.

It may be that early recognition and treatment can help prevent women becoming temporarily or permanently disabled

Mr Rami Hussein,
Mr Hussein, and Professor Fred Heatley, who is leading the research team are focussing their work on a key joint at the front of the pelvis.

The pubic symphysis naturally widens - to as much as one centimetre - during pregnancy and childbirth.

It usually closes up after the woman has given birth, but in some cases, it widens too much and the pelvis becomes unstable, causing the woman pain.

Sixty women are due to take part in the St Thomas's study, some of whom have had surgery.

The team will look at who has benefited and what the best way of managing the condition and reducing its incidence are.

Women will be asked about their pregnancies, when the pelvic pain started and what kind of delivery they had.

Measuring instability is difficult, but the scientists will take x-rays of their pelvis, and in some cases, MRI scans will also be taken of the symphysis.

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