Title : Pelvic fractures in pregnancy: Multidisciplinary management and outcomes
Abstract:
Background/Synopsis: Pelvic fractures during pregnancy present significant clinical challenges due to anatomical and physiological adaptations, requiring multidisciplinary care. High-energy trauma, including motor vehicle accidents, is the leading cause, with risks of preterm labor, placental abruption, and maternal mortality. Limited evidence-based guidelines highlight the need for integrated approaches to optimize maternal-fetal outcomes.
Objectives/Purpose: To evaluate the epidemiology, diagnostic modalities, management strategies, and outcomes of pelvic fractures in pregnancy, emphasizing the role of multidisciplinary collaboration.
Design/Methods: This study integrates data from peer-reviewed literature, synthesizing evidence on the pathophysiology, diagnosis, management, and outcomes of pelvic fractures in pregnant patients. A case-based review highlights clinical challenges and successful interventions.
Results: Motor vehicle accidents account for 60% of pelvic fractures during pregnancy, with maternal mortality rates ranging from 10% to 15%. Key complications include preterm labor (30–50%) and placental abruption (20%). Non-surgical management suffices for stable fractures, while surgical intervention, including minimally invasive fixation, ensures favorable outcomes for unstable fractures. Multidisciplinary care achieves maternal survival rates of 95%. Advances in imaging, such as MRI and low-dose CT, improve diagnostic accuracy with minimal fetal risk.
Conclusion: Pelvic fractures in pregnancy necessitate a multidisciplinary approach for optimal outcomes. Coordinated care between orthopedics, obstetrics, and anesthesiology is critical. Further research on pregnancy-specific surgical techniques and long-term outcomes is needed. Public health initiatives focusing on trauma prevention, such as road safety education, can reduce incidence rates. These findings underscore the importance of evidence-based guidelines to improve care and reduce maternal-fetal morbidity and mortality.
