ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2024
Should a history of pelvic fracture fixation be an indication for cesarean section?
Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Successful internal fixation of a pelvic ring fracture during pregnancy: a multidisciplinary case report.BMC pregnancy and childbirth · 2025Article
- The mode of delivery after operative fixation of pelvic ring fractures-a retrospective observational study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Observational
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Authors and funding
5 authors.
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Abstract
purposeTo 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).
methodsA 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.
resultsThe 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).
conclusionsA 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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