|
Vaginal delivery OK after total hip
replacement - Studies Show Low Risk
Vaginal delivery is feasible for women who
have undergone total hip replacement, according to data from two
studies presented at the annual meeting of the American Academy
of Orthopaedic Surgeons.
One study, presented by Dr. Rafael J. Sierra
of the Mayo Clinic, Rochester, Minn., retrospectively reviewed
343 women aged 18-45 years who had primary total hip
replacements between 1975 and 1995. A total of 57 of these women
together had 108 pregnancies after hip replacements during the
study period. The babies were delivered by cesarean section in
20 patients and vaginally in 31 patients; the delivery method
was unknown for the remaining 6 patients. Of the 57 women who
became pregnant after total hip replacement, 8 (14%) noted
increased hip pain during pregnancy and approximately half of
these reported persistent hip pain post pregnancy.
The risk of hip revision surgery after
pregnancy and childbirth was not significantly different among
patients after adjusting for age, but revision risk was 17 times
higher in women who have had at least one child, after total hip
replacement when not adjusted for age. The mean time from total
hip replacement to first successful pregnancy was 3;8 years,
ranging from 7 months to 10.7 years.
In a second study--a retrospective look at a
single surgeon's practice from 1981 to 2000--12% of 109 women
aged 45 years and younger had a least one successful pregnancy
an average of 3 years after total hip replacement.
Pregnancy-related complications were not increased as a result
of hip replacement, nor were revision rates significantly
increased, said Dr. Russell Meldrum of Indiana University
Indianapolis.
Of 20 pregnancies reported by 13 patients, 11
babies were delivered vaginally 5 by planned cesarean section,
3. by unplanned cesarean section, and I was terminated due to
feral lung malformation. No complications were related to the
presence of a hip implant. However, since younger patients who
undergo total hip replacement may have other significant health
problems, the researchers recommended medical clearance for hip
replacement patients before pregnancy. |
