EP6.52 Pregnancy and methods of delivery following pelvic osteotomy: a review of 1,146 patients in England from 2010 to 2023

Introduction: Pelvic osteotomy (PO) techniques are the mainstay of treating symptomatic hip dysplasia, which commonly affects women of reproductive age. However, the effects of PO on future pregnancies are unclear, despite patients expressing concerns about this. This study describes pregnancy-related outcomes following PO in England between 2010 and 2023, focussing on frequency, timing and methods of delivery.

Methods: The National Hospital Episode Statistics (HES) database was retrospectively reviewed to identify all female patients aged 16-45 who had POs in NHS England hospitals from April 2010 to March 2023, using relevant OPCS-4 codes. We collected data on patient demographics, and delivery episodes, including timing and method of delivery (spontaneous, Caesarean section, or other/unknown). Descriptive statistical methods were to calculate the mean time to delivery episodes following PO surgery, grouped by the chronicity of delivery.

Results: In total, 1,207 female patients who underwent PO were identified from the HES database, of which 1,146 were of reproductive age (mean age: 29.0, SD 8.73 years). Of these, 221 patients had 266 recorded childbirth episodes, at a mean of 4.60 years postoperatively. There were 105 (39%) spontaneous vaginal deliveries (SVD), 96 (36%) Caesarean sections (CS) and 65 (25%) other/unknown. There were 181 ‘first’ childbirth episodes, at a mean of 3.86 years postoperatively, with 64 (35%) SVD, 68 (38%) CS and 49 (27%) other/unknown.

Conclusions: This large population-based study using national data demonstrates most women delay childbirth following PO surgery and are more likely to have a Caesarean section for their first delivery. PO does not preclude the possibility of vaginal delivery, although the rates of Caesarean sections suggest that surgical history may influence delivery planning. This study contributes valuable insights for patients and clinicians regarding family planning and delivery options after PO surgery, however further research is required to confirm these results and investigate other factors influencing pregnancy-related outcomes in this population.