EP1.13 Pregnancy and Delivery Outcomes in Women with a History of Periacetabular Osteotomy

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ID: 331151
2026
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Abstract
Abstract Background Current literature suggests women who undergone periacetabular osteotomy (PAO) have increased rates of cesarean section (CS). Despite no established guidelines or risk related recommendations from orthopedic surgeons, many OBGYN recommend elective CS. This study aims to evaluate the mode of delivery, mode indications, and the maternal and neonatal outcomes in women after PAO. Methods A retrospective review was conducted of all female patients who underwent PAO by a single surgeon at a single academic institution between October 2012 and April 2025. Inclusion criteria were age ≥18 years and at least 9 months postoperative. Data were obtained from a patient-completed obstetric history survey and electronic medical record review. Variables included gravidity, mode of delivery (normal vaginal delivery [NVD] vs assisted VD vs CS), gestational age, birth weight, maternal and neonatal complications, and obstetric provider recommendations. Results Thirty women (37 hips) were included, accounting for 40 deliveries after PAO (including one twin pregnancy). Among 23 primiparous patients, 18 (78%) had VD and 5 (22%) underwent CS (3 elective, 2 intrapartum). Among the 7 multiparous patients, 5 (72%) had NVD and 2 (28%) required CS (1 elective, 1 intrapartum). Nine women had a second delivery post-PAO (7 [78%] NVD, 2 [22%] CS), and one had a third via VD. Mean gestational age was 38.4 weeks (range 30–40), and mean birth weight was 6.7 lbs (range 3–9.6). One major complication occurred (postpartum hemorrhage with retained placenta). Of 33 obstetric providers reported, 33% expressed concern regarding PAO-related delivery risk; however, 84.8% made no specific recommendation, 9.1% recommended VD, and 6.1% recommended elective CS. Conclusion Vaginal delivery is feasible and commonly achieved following PAO, with 85% of primiparous women successfully delivering vaginally in this study. Additionally, post-PAO pelvic morphology does not appear to adversely affect fetal development or the ability to carry a pregnancy to term; intrapartum CS rate (14%) and preterm birth (5%) rates were notably lower than national averages, 22% and 10%, respectively, and mean birthweight was comparable. The discrepancy between clinical outcomes and obstetricians’ concerns highlights the need for improved interdisciplinary communication and education regarding delivery planning after PAO.
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Authors Claire Noyes, Omer Mei-Dan, Erel Ben-Ari, Jessica Lee, Elad Mei‐Dan
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.197
URL
https://doi.org/10.1093/jhps/hnag043.197
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