Combined Acetabulum Fracture and Hip Dislocation in an 18-Year-Old Female at 35-Week Gestation: A Case Report and Review of the Literature

Caring for an injured, pregnant patient can be a management challenge. We report the case of an 18-year-old female who sustained a left acetabulum fracture with a concurrent hip dislocation at 35 weeks’ gestation following a motor vehicle accident. Through an interdisciplinary, team-based approach, the patient was guided through obstetric delivery and orthopedic surgical fracture fixation without complication. By being familiar with the unique challenges in management posed by pregnant patients, orthopedic surgeons can be better equipped to minimize morbidity and mortality in this patient population while maximizing clinical outcomes.

OBSTETRICIANS’ TACTICS IN THE DELIVERY BY PATIENTS WITH BREECH POSITION OF THE FOETUS AFFECTED BY THE UTERINE MYOMA

The aim of the study – improvement of pregnancy outcomes in women with pelvic presentation on the background of uterine myoma by developing optimal obstetric delivery tactics. Materials and Methods. In order to achieve the stated goal, a prospective analysis of cases of first- and second-time delivering patients with full-term one fetus pregnancy in pelvic presentation (incomplete and complete) amid the uterine myoma – the main group (MG) – (n = 30) was conducted. Into the control group (CG) – (n = 30) were included the first- and second-time bearing women without fetal myoma with full-time pregnancy and the pelvic presentation. Statistical processing of the results was performed using the Microsoft Office Excel 2017 software. Results and Discussion. The analysis of the presented data shows that among pregnant women with pelvic prevalence of fetuses on the background of uterine fibroids, more frequent cases are registered: clinical manifestations of the threat of interruption of pregnancy MG – 26 (86.7 %), CG – 9 (30 %) and pre-eclampsia MG – 8 (26.7 %), CG – 3 (10 %) (p < 0.05). Raising the risk of complications of pregnancy and the expected birth of the uterine myoma requires pre-planning for the most part the operational method of delivery of MG – 19 (63.3 %). Exception, in the absence of other contraindications, there may be women with single myomatous nodes in sizes up to 5 cm – 11 (36.7 %). Only the extension of the cesarean section requires only pregnant women with uterine myoma 7 (36.8 %), and most of these interventions occur during precarious surgical delivery 4 (20 %). Conclusion. Consequently, the presented data indicate the expediency and validity of taking into account the presence of uterine myoma at BP in order to develop an optimal obstetric tactic for the delivery of such patients in order to improve their pregnancy outcomes.