From 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).
J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 6;8(2). doi: 10.5435/JAAOSGlobal-D-23-00203. eCollection 2024 Feb 1.
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.
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.
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.
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.
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.
骨盆环损伤的发病率为每 10 万人中有 34.3%。目前尚无研究确定骨盆骨折固定后女性患者进行阴道分娩的能力。然而，许多妇产科医生通常不愿意让接受耻骨联合或骶髂关节固定的患者尝试阴道分娩。
对美国国家医学图书馆数据库进行了全面检索，假设骨盆环损伤后生育的女性行剖宫产的比例会更高。
根据国家卫生统计中心的数据，剖宫产率增加了 15%。此外，新的剖宫产率也有所增加。
目前，没有明确的证据支持在先前骨盆骨折后将选择性剖宫产作为唯一指征。迄今为止，尚无研究确定骨盆骨折固定后女性患者进行阴道分娩的能力。
因此，在解释剖宫产率增加的原因之前，建议骨盆环骨折患者避免阴道分娩可能会有问题。因此，有必要就这一主题进行更多的研究。
