OJOG  Vol.4 No.14 , October 2014
Vaginal Delivery after Pelvic Fracture Fixation with a Subcutaneous Anterior Fixator with Review of Literature of Delivery Mode in Pelvic Injuries
Background: The cesarean section rate following a pelvic fracture is more than double the standard norms. This results from residual deformity and a lack of knowledge among obstetricians regarding the ability to deliver vaginally after a pelvic fracture. Aim: To present a case of pelvic fracture that delivered vaginally indicating vaginal delivery is possible even after pelvic fractures that are stabilized surgically with minimal or no residual displacement. Case presentation: We present a patient that delivered vaginally following internal fixation of an unstable pelvic fracture with a retained orthopedic implant that spanned the lower abdomen with a metallic bar. We also discuss the role of cesarean section in patients with pelvic fractures. Conclusion: Women with pelvic fractures may possibly deliver vaginally however decision regarding mode of delivery in such patients should be on a case by case basis.

Cite this paper
Sethi, A. , Vaidya, R. , Schneider, S. , Fleming, J. and Oliphant, B. (2014) Vaginal Delivery after Pelvic Fracture Fixation with a Subcutaneous Anterior Fixator with Review of Literature of Delivery Mode in Pelvic Injuries. Open Journal of Obstetrics and Gynecology, 4, 836-839. doi: 10.4236/ojog.2014.414117.
[1]   Vallier, H.A., Cureton, B.A. and Schubeck, D. (2012) Pelvic Ring Injury Is Associated with Sexual Dysfunction in Women. Journal of Orthopaedic Trauma, 26, 308-313.

[2]   Vallier, H.A., Cureton, B.A. and Schubeck, D. (2012) Pregnancy Outcomes after Pelvic Ring Injury. Journal of Orthopaedic Trauma, 26, 302-307.

[3]   Vaidya, R., Colen, R., Vigdorchik, J., Tonnos, F. and Sethi, A. (2012) Treatment of Unstable Pelvic Ring Injuries with an Internal Anterior Fixator and Posterior Fixation: Initial Clinical Series. Journal of Orthopaedic Trauma, 26, 1-8. http://dx.doi.org/10.1097/BOT.0b013e318233b8a7

[4]   Vaidya, R., Kubiak, E.N., Bergin, P.F., Dombroski, D.G., Critchlow, R.J., Sethi, A. and Starr, A.J. (2012) Complications of Anterior Subcutaneous Internal Fixation for Unstable Pelvis Fractures: A Multicenter Study. Clinical Orthopaedics and Related Research, 470, 2124-2131.

[5]   Dunivan, G.C., Hickman, A.M. and Connolly, A. (2009) Severe Separation of the Pubic Symphysis and Prompt Orthopedic Surgical Intervention. Obstetrics Gynecology, 114, 473-475.

[6]   Najibi, S., Tannast, M., Klenck, R.E. and Matta, J.M. (2010) Internal Fixation of Symphyseal Disruption Resulting from Childbirth. Journal of Orthopaedic Trauma, 24, 732-739.

[7]   Vaidya, R., Oliphant, B., Jain, R., Nasr, K., Siwiec, R., Onwudiwe, N. and Sethi, A. (2013) The Bikini Area and Bikini Line as a Location for Anterior Subcutaneous Pelvic Fixation: An Anatomic and Clinical Investigation. Clinical Anatomy, 26, 392-399. http://dx.doi.org/10.1002/ca.22149

[8]   Copeland, C.E., Bosse, M.J., McCarthy, M.L., MacKenzie, E.J., Guzinski, G.M., Hash, C.S. and Burgess, A.R. (1997) Effect of Trauma and Pelvic Fracture on Female Genitourinary, Sexual, and Reproductive Function. Journal of Orthopaedic Trauma, 11, 73-81.

[9]   Cannada, L.K., Pan, P., Casey, B.M., McIntire, D.D., Shafi, S. and Leveno, K.J. (2010) Pregnancy Outcomes after Orthopedic Trauma. The Journal of Trauma, 69, 694-698.

[10]   http://www.cdc.gov/nchs/data/nvsr/nvsr62/nvsr62_09.pdf#table21

[11]   Papakostidis, C., Kanakaris, N.K., Kontakis, G. and Giannoudis, P.V. (2009) Pelvic Ring Disruptions: Treatment Modalities and Analysis of Outcomes. International Orthopaedics, 33, 329-338.

[12]   Bucholz, R.W., Heckman, J.D., Coutr-Brown, C., Eds. (2006) Rockwood and Green’s Fractures in Adults. 6th Edition, Lippincott Williams & Wilkins, Philadelphia.