Managing Complications in Pregnancy and Childbirth: - IAWG

SymphysiotomyP-55• Apply antiseptic solution to the suprapubic skin (page C-22).• Wearing high-level disinfected gloves, place an index finger in thevagina and push the catheter, and with it the urethra, away fromthe midline (Fig P-26).FIGURE P-26Pushing urethra to one side after inserting thecatheter• With the other hand, use a thick, firm-bladed scalpel to make avertical stab incision over the symphysis.• Keeping to the midline, cut down through the cartilage joining thetwo pubic bones until the pressure of the scalpel blade is felt onthe finger in the vagina.• Cut the cartilage downwards to the bottom of the symphysis, thenrotate the blade and cut upwards to the top of the symphysis.• Once the symphysis has been divided through its whole length,the pubic bones will separate.FIGURE P- 27 Dividing thecartilage