Related Experiment Video
Updated: Jul 5, 2026
Intraoperative Ultrasound in Spinal Surgery
Published on: August 17, 2022
Should a history of pelvic fracture fixation be an indication for cesarean section?
Joshua A Parry1, Katya E Strage2, Alex Lencioni2
1Department of Orthopaedics, Denver Health Medical Center, University of Colorado Medical School, Denver Health, 777 Bannock St., MC 0188, Denver, CO, 80204, USA. Joshua.parry@dhha.org.
Purpose:
To compare the success rate of a trial of labor (TOL) in a cohort of patients with pelvic fractures, with and without internal fixation, in order to better counsel patients and avoid unnecessary cesarean section (CS).
Methods:
A retrospective review of 35 female patients with 28 pelvic ring, five acetabular, and two combined fractures that had subsequent pregnancy; 12 patients had operative fixation and 23 did not. Fracture classification, treatment, type of fixation, mode of deliveries, and reason for CS were documented.
Results:
The rate of vaginal delivery, unscheduled CS, and scheduled CS across all patients was 80.0% (n = 28), 14.3% (n = 5), and 5.7% (n = 2), respectively, which was similar to institutional rates of 87.0, 12.0, and 1.0%. A TOL was attempted in 91.4% (32/35) and successful in 87.5% (28/32). Patients who failed a TOL were more likely to have Tile B/C pelvic fractures (100.0 vs. 30.4%, observed difference (OD) 69.6%, 95% confidence interval (CI) 16.4, 86.3%; p = 0.01) and more pelvic displacement (6.0 vs. 1.5 mm, OD 4.0, CI 1.0, 18.0; p = 0.01). The fixation and control groups had no observed difference in successful TOL (72.7% vs. 95.2%, OD 22.5%, - 49.7%, 5.5%; p = 0.10).
Conclusions:
A majority of women had successful vaginal deliveries after pelvic fractures, with or without fixation, suggesting that these patients should consider a TOL.
Level Of Evidence:
Diagnostic Level III.
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