Clinical Review
Management of Pelvic Fractures During Pregnancy
Am J Orthop. 2007 November;36(11):E153-E159
Author and Disclosure Information
Gil Almog, MD, Meir Liebergall, MD, Avi Tsafrir, MD, Yair Barzilay, MD, and Rami Mosheiff, MD
Dr. Almog is Attending Surgeon, and Dr. Liebergall is Chairman and Professor of Orthopedic Surgery, Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Dr. Tsafrir is Attending Surgeon, Department of Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Dr. Barzilay is Attending Surgeon, and Dr. Mosheiff is Associate Professor of Orthopedic Surgery and Head of Trauma Service, Department of Orthopedic Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
Pelvic or acetabular fractures during pregnancy are rare, and information on managing such complex incidents has been limited. Over several years, we have gained significant experience in handling such cases. Of the 1345 pelvic and acetabular fractures treated at our level I trauma center between 1987 and 2002, 15 (1.1%) occurred in pregnant women. Eleven women received conservative treatment, and 4 were treated surgically. Of the 16 fetuses, 12 survived, and 4 pregnant women had nonviable pregnancies. One of the 15 pregnant women died. We describe our cases and propose treatment guidelines. The dilemma presented in a multitrauma situation at various stages of pregnancy necessitates making management modifications involving timing of surgery and delivery, use of radiation for imaging, and choice of appropriate surgical procedure.