rivka: (her majesty)
[personal profile] rivka
Yazici Y, Erkan D, Zuniga R, Bateman H, Salvati EA, Magid SK. Pregnancy outcomes following total hip arthroplasty: A preliminary study and review of the literature. Orthopedics 2003; 26:75-76.

McDowell CM, Lachiewicz PF. Pregnancy after total hip arthroplasty. Journal of Bone and Joint Surgery 2001; 83A:1490-1494.

These two confirm what Dr. Callaghan told me after my hip replacement: it shouldn't have any effect on pregnancy, labor, or delivery. One article mentions the possibility of a greater risk of hip dislocation, due to hormonally relaxed ligaments, but apparently this hasn't actually happened to anyone. I would probably want to go back to some of the dislocation precautions I followed after surgery, just in case.

Loder RT. The long-term effect of pelvic osteotomy on birth canal size. Archives of Orthopedic and Trauma Surgery 2002; 122:29-34.

Again, confirms what Dr. Callaghan said - if I have any hip-related complications, they'll be due to the Chiari osteotomy I had in 1993. He said that I had the potential for a normal vaginal delivery, but would also have a higher-than-normal risk of C-section. This article provided a lot more detail: for example, I now know that the C-section rate for Chiari osteotomy patients is 25-30%, which is actually not particularly high. Also, the article provides specific pelvic measurements associated with increased C-section risk after Chiari, which ought to mean that we'll be able to tell whether I'm at higher risk just by looking at my X-rays. So I'm really pleased that I found that one.

I actually don't mind the idea of having a C-section. Surgery doesn't freak me out, obviously, and since I've had pelvic problems all my life, I never really let myself get attached to the idea of a beautiful, natural, low-tech delivery. What I mind is the idea of being designated a "high-risk" pregnancy from the start. I'm worried that the midwife practice won't accept me because they'll worry about my orthopedic history. I have a back-up recommendation - my friend Michelle loved her obstetrician - but I think you get more personal and less medicalized care from midwives.
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