logo
episode-header-image
Sep 3
26m 37s

Can SVD Occur After Pelvic Fracture?

DR. CHAPA’S CLINICAL PEARLS
About this episode

According to the J Am Acad Orthop Surg Glob Res Rev. (2024), the incidence of pelvic ring injuries is 34.3 per 100,000 with trauma being the most obvious causation. Women account for approximately 69.7% of these injuries, 23% of which occur in women of childbearing age. In this specific patient population, concern is raised about one's future reproductive capability and method of delivery. The normal bony pelvic movements that occur during vaginal delivery are crucial for accommodating the passage of the fetus through the birth canal; this allows for the normal cardinal phases of labor to occur. These movements involve the widening and shifting of various pelvic joints and bones, primarily influenced by hormonal changes and the mechanical forces exerted by the baby. So, it is reasonable to ask if a patient with pelvic fractures and fixation can safely allow a trial of labor. Is a history of pelvic fractures with surgical fixation an indication for primary cesarean section? If it’s not, in what scenario would a primary c-section be best after a pelvic fracture? Listen in for details.

1.Pelvic Fractures in Women of Childbearing Age.Cannada LK, Barr J. Clinical Orthopaedics and Related Research. 2010;468(7):1781-9. doi:10.1007/s11999-010-1289-5.

2.Birth Outcomes Following Pelvic Ring Injury: A Retrospective Study. Hsu CC, Lai CY, Chueh HY, et al. BJOG : An International Journal of Obstetrics and Gynaecology. 2023;130(11):1395-1402. doi:10.1111/1471-0528.17487.

3.Pregnancy and Delivery After Pelvic Fracture in Fertile-Aged Women: A Nationwide Population-Based Cohort Study in Finland. Vaajala M, Kuitunen I, Nyrhi L, et al. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2022;270:126-132. doi:10.1016/j.ejogrb.2022.01.008.

4.Pregnancy Outcomes After Pelvic Ring Injury.Vallier HA, Cureton BA, Schubeck D. Journal of Orthopaedic Trauma. 2012;26(5):302-7. doi:10.1097/BOT.0b013e31822428c5.

5.Caesarean Section Rates Following Pelvic Fracture: A Systematic Review. Riehl JT. Injury. 2014;45(10):1516-21. doi:10.1016/j.injury.2014.03.018.

6.Unstable Pelvic Fractures in Women: Implications on Obstetric Outcome. Davidson A, Giannoudis VP, Kotsarinis G, et al. International Orthopaedics. 2024;48(1):235-241. doi:10.1007/s00264-023-05979-4.

7.Management of Pelvic Injuries in Pregnancy.Amorosa LF, Amorosa JH, Wellman DS, Lorich DG, Helfet DL. The Orthopedic Clinics of North America. 2013;44(3):301-15, viii. doi:10.1016/j.ocl.2013.03.005

8.Effect of Trauma and Pelvic Fracture on Female Genitourinary, Sexual, and Reproductive Function.Copeland CE, Bosse MJ, McCarthy ML, et al. Journal of Orthopaedic Trauma. 1997 Feb-Mar;11(2):73-81. doi:10.1097/00005131-199702000-00001.

9. The Rate of Elective Cesarean Section After Pelvic or Hip Fracture Remains High Even After the Long-Term Follow-Up: A Nationwide Register-Based Study in Finland. Vaajala M, Kuitunen I, Liukkonen R, et al.European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2022;277:77-83. doi:10.1016/j.ejogrb.2022.08.

10. Bajerová M, Hruban L. Movements of the pelvic bones of expectant mothers during vaginal delivery. Ceska Gynekol. 2024;89(4):335-342. English. doi: 10.48095/cccg2024335. PMID: 39242210.

11. Lewis AJ, Barker EP, Griswold BG, Blair JA, Davis JM. Pelvic Ring Fracture Management and Subsequent Pregnancy: A Summary of Current Literature. J Am Acad Orthop Surg Glob Res Rev. 2024 Feb 6;8(2):e23.00203. doi: 10.5435/JAAOSGlobal-D-23-00203. PMID: 38323930; PMCID: PMC10849384.

12. Childbirth after Pelvic Fractures: Debunking the Myths: https://ota.org/sites/files/legacy_abstracts/ota09/otapa/OTA090132.htm

13. Davidson A, Giannoudis VP, Kotsarinis G, Santolini E, Tingerides C, Koneru A, Kanakaris NK, Giannoudis PV. Unstable pelvic fractures in women: implications on obstetric outcome. Int Orthop. 2024 Jan;48(1):235-241. doi: 10.1007/s00264-023-05979-4. Epub 2023 Sep 15. PMID: 37710070


Up next
Today
“New” CPU on Zuranolone? “NOTHING” .
On October 9, 2025, the ACOG released a clinical practice update (CPU) regarding Zouranolone and brexanolone. As postpartum depression is an area of continued research and need for therapeutics, any new clinical practice update on the subject is welcome. So what's new in this upd ... Show More
22m 32s
Oct 7
What Did You say?!
Sometimes you hear something that makes you just stop and say, “What did you say?!”. Yep, in this episode we will give evidence-based answers to three questions that I heard TODAY that made me stop and ask, “What did you say?”. In this episode we will cover: 1. Umbilical cord blo ... Show More
24m 20s
Oct 5
SCIENCE CHANGES: New Data on HPV Vaccination Peri-Leep/Cone
In July 2023, the ACOG released a Practice Advisory stating, “Based on data on the benefit of adjunct HPV vaccination, ACOG recommends adherence to the current Centers for Disease Control and Prevention (CDC) recommendations for vaccinations of individuals aged 9–26 years, and to ... Show More
30m 34s
Recommended Episodes
May 2024
EP 134: Prenatal genetic testing and the future of AI in genetic counselling with Kira Dineen, host of DNA Today
In episode 134, we welcome fellow genetics podcaster Kira Dineen. Kira is most widely known for her award winning podcast, DNA Today, as well as producing a number of other health and science podcasts. Now running for more than 10 years, DNA Today is the winner of the 2020, 2021, ... Show More
40m 44s
Oct 2024
Microbes Are Evolving to Eat Cleaning Supplies, and Whooping Cough Is Making a Comeback
NASA and the National Oceanic and Atmospheric Administration have confirmed we’re in the solar maximum, a period of increased solar activity that could lead to more auroras. Also, the Centers for Disease Control and Prevention has reported a fivefold surge in whooping cough cases ... Show More
9m 13s
Oct 2024
Microbes Are Evolving to Eat Cleaning Supplies, and Whooping Cough Is Making a Comeback
NASA and the National Oceanic and Atmospheric Administration have confirmed we’re in the solar maximum, a period of increased solar activity that could lead to more auroras. Also, the Centers for Disease Control and Prevention has reported a fivefold surge in whooping cough cases ... Show More
9m 13s
May 2025
EP 185: From newborn screening to lifelong data in an evolving genomics landscape with Madhuri Hegde of Revvity
This week on The Genetics Podcast, Patrick is joined by Madhuri Hegde, SVP and Chief Scientific Officer of Revvity. They discuss Revvity’s advances in ultra-rapid clinical-grade sequencing, opportunities, challenges, and global inequities in newborn screening, and the dilemma of ... Show More
40m 44s
Sep 29
Tylenol and Autism, a Shark Threesome and a Typhoon
This week’s roundup breaks down the Food and Drug Administration’s decision to revise the safety label for acetaminophen (Tylenol) following the Trump administration’s misleading claims about a link between use of the drug during pregnancy and autism—which were made despite incon ... Show More
12m 15s
Sep 2024
The sweeping reorganisation of the brain in pregnancy, and why it matters
Ian Sample talks to Dr Laura Pritschet, a postdoctoral fellow of psychiatry at the University of Pennsylvania, about her research using precision scans to capture the profound changes that sweep across the brain during pregnancy. She explains what this new work reveals about how ... Show More
14m 25s
Jan 2025
Rachel Chevalier - Update on Topical Steroids for EoE
In this episode, hosts Drs. Temara Hajjat and Jenn Lee talk to Dr. Rachel Chevalier. Dr. Chevalier is a pediatric gastroenterologist and physician scientist at Children's Mecy Hospital. She is an Associate Professor at the University of Missouri-Kansas City School of Medicin ... Show More
54m 42s
Dec 2024
Episode 935: Pregnancy Extremis - TOLDD
Contributor: Aaron Lessen MD Educational Pearls: Pregnant patients at high risk of cardiac arrest, in cardiac arrest, or in extremis require special care A useful mnemonic to recall the appropriate management of critically ill pregnant patients is TOLDD T: Tilt the patient to the ... Show More
3m 26s
May 2023
When We Age
How do our brains change as we get older? Why are we more likely to develop Alzheimer’s or experience a stroke late in life? And what can you do to help protect your neural health? In this episode of How We’re Wired, join evolutionary anthropologist Dr Anna Machin as she unpicks ... Show More
26m 54s
Sep 22
Vaccine Shakeups, Brain Injury Warnings and Boozy Chimps
The Centers for Disease Control and Prevention’s vaccine advisory committee has been reshaped, with new recommendations on the horizon. Meanwhile studies reveal subtle brain changes in contact sports players and highlight ongoing risks of repetitive head injuries. Climate change ... Show More
10m 49s