High Rate of C-sections After Pelvic Fractures

Introduction

Main Digest

In research led by a Saint Louis University surgeon, investigators found that women who give birth after suffering pelvic fractures receive C-sections at more than double normal rates despite the fact that vaginal delivery after such injuries is possible. In addition, women reported lingering, yet often treatable, symptoms following their pelvic fracture injuries, from urinary complications to post-traumatic stress disorder.

The study, published in Clinical Orthopaedics and Related Research, retrospectively reviewed the cases of 71 women who had suffered pelvic fractures, 26 of whom subsequently had children. Of those 26 women, 10 delivered vaginally and 16 gave birth by C-section.

More than 100,000 patients are treated for pelvic fractures each year in the U.S., most commonly after car accident injuries.

Lisa Cannada, M.D., associate professor of orthopaedic surgery sub-specializing in traumatology at Saint Louis University and lead researcher, says the study offers important information women should discuss with their doctors.

"The C-section rate is so high. It's important to educate women and their obstetricians that it is possible to deliver vaginally after a pelvic fracture," said Cannada, who is also a SLUCare orthopaedic surgeon.

"Frequently, these issues are not addressed when women are first treated for a fracture. In some cases, women are given inaccurate information, such as being told not to become pregnant after a pelvic fracture or that they must have a C-section. This is not the case."

Researchers also found that, in addition to anxiety about future pregnancies, women expressed concern about symptoms related to their injuries and also frequently suffered from urinary symptoms and discomfort during sex.

"We've found that many women worry about whether or not they can have children and what type of delivery will be possible," Cannada said. "Women also worry about pain during sex and urinary issues."

In many cases, Cannada says, women do not realize their symptoms are related to the fracture they suffered. Urinary issues, sexual dysfunction and post-traumatic stress disorder all can follow a pelvic fracture.

Cannada says it's important for women to know that there are effective treatment options for these issues.

"Take charge," Cannada says. "Don't let a pelvic fracture affect your life or decision to have kids. Talk to your OB/GYN and find out what your best options are."

The study was funded by the Foundation for Orthopaedic Trauma and the Ruth Jackson Orthopaedic Society Zimmer Research Award.

Study highlights:

Pelvic fractures should not deter women from having children.

It is possible to deliver vaginally after a pelvic fracture.

Many women experience urinary symptoms or painful sex following a pelvic fracture. Women should consult their doctors because effective treatments are available.

Post-traumatic stress disorder is common after a trauma. It, too, has effective treatments.

Established in 1836, Saint Louis University School of Medicine has the distinction of awarding the first medical degree west of the Mississippi River. The school educates physicians and biomedical scientists, conducts medical research, and provides health care on a local, national and international level. Research at the school seeks new cures and treatments in five key areas: cancer, liver disease, heart/lung disease, aging and brain disease, and infectious disease.

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