Scott Department of Urology, Baylor Plaza College of Medicine, Houston, TX, 77030, USA.
Arch Gynecol Obstet. 2024 Oct;310(4):2269-2271. doi: 10.1007/s00404-024-07705-w. Epub 2024 Aug 31.
Pelvic fractures significantly impact young individuals, with a prevalence of 20 per 100,000, leading to long-term complications such as chronic pain and genitourinary dysfunction. Notably, women with a history of pelvic fractures face increased cesarean section (C-sections) rates during childbirth. This editorial investigates the factors contributing to higher C-section rates in these women, including provider assumptions about delivery complications and systemic hospital biases. Despite these trends, evidence suggests that vaginal delivery can be successful, especially when considering factors like pelvic displacement and the timing of delivery post-fracture. We advocate for education programs to challenge provider biases, transparent patient communication, and evidence-based practices prioritizing patient-centered care. Addressing these issues can enhance maternal and fetal outcomes, supporting women in making informed decisions about their delivery options.
骨盆骨折对年轻人影响重大，其发病率为每 10 万人中有 20 例，可导致长期并发症，如慢性疼痛和泌尿生殖功能障碍。值得注意的是，有骨盆骨折病史的女性在分娩时剖宫产（C -section）的比例更高。本社论探讨了导致这些女性剖宫产率升高的因素，包括提供者对分娩并发症的假设和系统医院的偏见。尽管存在这些趋势，但有证据表明阴道分娩可以成功，特别是在考虑骨盆移位和骨折后分娩时机等因素时。我们主张开展教育计划，以挑战提供者的偏见、进行透明的医患沟通，并优先考虑以患者为中心的循证实践。解决这些问题可以改善母婴结局，支持女性做出知情的分娩选择。
