PELVIC FRACTURES IN PREGNANCY: DIAGNOSIS, ORTHOPEDIC MANAGEMENT, AND OBSTETRIC IMPLICATIONS
DOI:
https://doi.org/10.56238/levv16n54-149Keywords:
Pelvic Fracture, Pregnancy, TraumaAbstract
Introduction: Pelvic fractures in pregnancy are rare but clinically complex events, associated with a higher risk of hemodynamic instability, hemorrhage and adverse obstetric outcomes. The need to protect both maternal and fetal well-being makes diagnostic workup and orthopedic management particularly challenging. Methods: A systematic literature review was performed in PubMed/MEDLINE, Scopus and Web of Science, including studies published between 1990 and 2025 in English, Portuguese or Spanish. Eligible articles reported pelvic ring fractures in pregnant women and described diagnostic methods, orthopedic management strategies and maternal and fetal outcomes. Titles, abstracts and full texts were screened, and 15 studies met the inclusion criteria and were incorporated into the qualitative synthesis. Results: The included studies comprised case reports, case series, retrospective cohorts, population-based studies and reviews. Most fractures resulted from high-energy trauma in women in the second or third trimester of pregnancy. Pelvic radiography was the most common initial imaging modality, frequently complemented by computed tomography; magnetic resonance imaging was used selectively, mainly for follow-up. Orthopedic management ranged from conservative treatment in stable fractures to external or internal fixation in unstable injuries. The most frequently reported maternal and fetal outcomes were hemorrhage, need for transfusion, preterm birth, increased cesarean section rate and fetal death in the most severe cases. Studies evaluating pregnancies after prior pelvic fracture showed that vaginal delivery was feasible in selected women without significant residual deformity. Conclusion: Pelvic fractures in pregnancy require multidisciplinary care, structured diagnostic pathways and individualized stabilization strategies. Standardized protocols and prospective studies are needed to refine decision-making regarding orthopedic management and mode of delivery, aiming to optimize both maternal and fetal outcomes.
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