EP8.58 Reproductive and Obstetric Outcomes Before and After Periacetabular Osteotomy

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ID: 331138
2026
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Abstract
Abstract Background Periacetabular osteotomy (PAO) is commonly performed in women of childbearing age; however, limited data exists regarding fertility, pregnancy outcomes, mode of delivery, and obstetric risk following surgery. A clearer understanding of pregnancy and delivery outcomes before and after PAO is critical to support informed counseling and shared decision-making. Methods Patient-reported survey data from women more than 10 years post-PAO (n=32) were analyzed to characterize reproductive history, pregnancy complications, and delivery outcomes before and after PAO. Survey data from obstetric providers (n = 9) were also analyzed to assess delivery recommendations, indications for cesarean delivery, and observed complications among patients with hip dysplasia or prior hip preservation surgery. Results Most respondents did not report infertility (81%), although when present, infertility was frequently associated with gynecologic comorbidities, including endometriosis, pelvic adhesions, tubal obstruction, and/or ovarian cysts. The average number of deliveries was slightly higher after PAO than before surgery (0.72 vs 0.59), suggesting that childbearing frequently occurred postoperatively. Vaginal delivery predominated prior to PAO, whereas cesarean delivery was more common after PAO. Cesarean delivery occurred in 7 of 19 pre-PAO deliveries (36.8%) and 12 of 23 post-PAO deliveries (52.2%), a difference that was not statistically different (Fisher exact test, p = 0.37). Post-PAO cesarean deliveries were most often attributed to PAO history or provider recommendation rather than emergency obstetric indications. Importantly, no obstetric providers reported delivery-related complications related to hip dysplasia or prior hip preservation surgery during vaginal delivery. Conclusions Pregnancy and delivery before and after PAO are generally well tolerated, with favorable maternal and neonatal outcomes. Although cesarean delivery occurred more frequently following PAO, there was no statistically significant difference, and these decisions were generally precautionary rather than driven by obstetric complications. The findings of this study support multidisciplinary counseling to inform delivery planning and align clinical recommendations with individual patient goals.
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Authors Amanda Paulson, Michael Willey, Courtney Seffker, Robert W. Westermann, Tony Pennuto
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.438
URL
https://doi.org/10.1093/jhps/hnag043.438
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