Lateral Compression-I Pelvic Ring Injury: Not Benign to the Developing Fetus

Area of Science:

• Orthopaedic trauma
• Maternal-fetal medicine
• Trauma surgery

Background:

• Pelvic ring and acetabular fractures can occur in pregnant patients.
• The association between specific pelvic fracture patterns and intrauterine fetal demise (IUFD) requires further investigation.

Purpose of the Study:

• To determine if specific pelvic ring injury patterns are associated with increased rates of IUFD.
• To identify risk factors for IUFD in pregnant patients with pelvic fractures.

Main Methods:

• Retrospective review of 44 pregnant patients with pelvic and/or acetabular fractures.
• Analysis of fetal viability records for 40 patients.
• Statistical analysis using chi-squared and t-tests to compare outcomes based on fracture type.

Main Results:

• Overall fetal mortality was 40%.
• No IUFD occurred with isolated acetabular fractures.
• Isolated pelvic ring injuries were associated with a 68% IUFD rate (P < 0.0001), with 62% of lateral compression type I injuries resulting in IUFD.
• Maternal Injury Severity Score and Glasgow Coma Scale predicted IUFD.

Conclusions:

• Lateral compression type I pelvic ring injuries are common in gravid trauma patients and carry a high risk of IUFD.
• While maternal mortality is low, the risk of fetal demise is significant, particularly with pelvic ring injuries.