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Pelvic Ring Fracture Management and Subsequent Pregnancy: A Summary of Current Literature
Allison J Lewis1, Elizabeth P Barker, B Gage Griswold
1From the Medical College of Georgia at Augusta University, Augusta, GA (Ms. Lewis); the University of South Carolina School of Medicine, Columbia, SC (Ms. Barker); the Western Orthopaedics, Denver, CO (Dr. Griswold); the Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA (Dr. Blair); and the Department of Orthopaedics and Rehabilitation, Penn State College of Medicine, Hershey, PA (Dr. Davis).
Introduction:
The incidence of pelvic ring injuries is 34.3% per 100,000 capita. No studies have determined the ability of a female patient to have a vaginal delivery after undergoing pelvic fracture fixation. However, many obstetricians are generally unwilling to have their patients attempt a vaginal delivery in the setting of symphyseal or sacroiliac fixation.
Methods:
An exhaustive search of the National Library of Medicine database was performed, and it is hypothesized that cesarean section rates would be higher for women who have a child after one of these pelvic ring injuries.
Results:
There is a 15% increase in cesarean rates using data from the National Center for Health Statistics. In addition, there is an observable increase in new cesarean rates.
Discussion:
Currently, there is no clear evidence to support an elective cesarean section as the sole indication after a prior pelvic fracture. To date, no studies have determined the ability of a female patient to have a vaginal delivery after undergoing pelvic fracture fixation.
Conclusion:
Thus, until the increased cesarean section rate has been explained, it could be problematic to counsel the patient to avoid a vaginal delivery after sustaining a pelvic ring fracture. Hence, conducting additional studies on this topic would deem to be necessary.
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