Shuhua Liu ^* Dehong Liu Qiuru Li Bin Zhang Xianxia Chen

• Anhui Maternal and Child Health Hospital, Hefei, Anhui Province, China

Background: Pregnancy following pelvic fixation due to trauma-induced hip comminuted fractures is extremely rare, and the impact on pregnancy and childbirth is unclear.We reported a 28-year-old pregnant woman at 34+3 weeks gestation who was underwent right pelvic fixation surgery and femoral neck fixation due to a comminuted fracture of 1/3 of the right hip bone and femoral neck fracture in a car accident in 2012. The fixation site extended from the right hip bone to the pubic symphysis and the right femoral head. Because of excessive anxiety and concern about the risk of pregnancy after pelvic fixation, elective cesarean section is required to terminate the pregnancy.The patient had a regular prenatal examination and no other complications. Physical examination after admission showed no contractions, no vaginal bleeding, discharge, normal fetal heartbeat, estimated fetal weight of 2000 g.Vaginal examination showed that the fetal head was in the entrance plane, -2 position.Pelvic CT three-dimensional reconstruction was undertaken after preoperative assessment.Dexamethasone was given to induce the maturation of the fetal lungs and a cesarean section was performed at 35 weeks gestation.The neonatal male weighed 1980 g, had an Apgar score of 9-10 points and was admitted to the NICU due to premature birth. Four days later, the mother and son were discharged from the hospital.Conclusions: Pregnancy after pelvic fixation due to trauma-induced hip comminuted fractures is extremely rare, and there is a risk of splitting at bone fissures, contusion, and maternal fetal injury in the third trimester.There is currently no convincing evidence to support vaginal delivery in patients with previous pelvic fractures undergoing internal fixation.After treatment to promote fetal lung maturation before 35 weeks, cesarean section was safe.