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妊娠发育性髋关节发育不良的当前证据。

Current Evidence about Developmental Dysplasia of the Hip in Pregnancy.

机构信息

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, Filantropia Clinical Hospital, 011171 Bucharest, Romania.

Department of Obstetrics and Gynecology, "Carol Davila" University of Medicine and Pharmacy, University Emergency Hospital, 050098 Bucharest, Romania.

出版信息

Medicina (Kaunas). 2021 Jun 26;57(7):655. doi: 10.3390/medicina57070655.

Abstract

In adults, developmental dysplasia of the hip (DDH) represents a spectrum of disorders. It is commonly found in women in routine orthopedic practice. Hip dysplasia is a leading precursor of joint laxity; when untreated, it can contribute to chronic modifications, such as thickening of the pulvinar and ligamentum teres (which can also elongate), hypertrophy of the transverse acetabular ligament, and osteoarthritis. DDH is presumed to be associated with alterations in pelvic morphology that may affect vaginal birth by the reduction in the transverse diameter of the pelvic inlet or outlet. Here, we provide an overview of the current knowledge of pregnancy-associated DDH. We primarily focused on how a surgical DDH treatment might influence the pelvic shape and size and the effects on the mechanism of birth. We presented the female pelvis from the standpoint of bone and ligament morphology relative to a pelvic osteotomy. Then, we described whether the pregnancy was impacted by previous surgical DDH treatments, performed from infancy to adulthood. In conclusion, hip dysplasia is not associated with high-risk complications during pregnancy or with increased difficulty in vaginal delivery.

摘要

在成年人中,发育性髋关节发育不良(DDH)代表了一系列疾病。在常规矫形实践中,女性中常见。髋关节发育不良是关节松弛的主要前驱病变;如果不治疗,它可能导致慢性改变,如 Pulvinar 和teres 韧带(也可能延长)增厚、横髋臼韧带肥大和骨关节炎。DDH 被认为与骨盆形态的改变有关,这些改变可能会通过减少骨盆入口或出口的横径来影响阴道分娩。在这里,我们提供了与妊娠相关的 DDH 的最新知识概述。我们主要关注的是手术治疗 DDH 如何影响骨盆的形状和大小,以及对分娩机制的影响。我们从与骨盆切开术相关的骨骼和韧带形态的角度描述了女性骨盆。然后,我们描述了先前从婴儿期到成年期进行的手术 DDH 治疗是否会影响妊娠。总之,髋关节发育不良与妊娠期间的高风险并发症或阴道分娩难度增加无关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ae15/8305660/f43f1afc00fc/medicina-57-00655-g001.jpg

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