Femoral fracture in pregnancy: a case series and review of clinical management

Abstract

Justin A Harold, Erin Isaacson, Anna PalatnikDepartment of Obstetrics and Gynecology, Medical College of Wisconsin, Milwaukee, WI, USAAbstract: Femoral fractures in pregnancy are a rare complication, with an incidence of approximately 1%. Case reports and small trials leave perioperative obstetric management and route of delivery largely unclear. Three cases of femoral fracture are presented that occurred at 24, 30, and 31 weeks of gestation. The causes of femoral fracture were gunshot, motor vehicle collision, and fragility fracture. All fractures were surgically repaired, 1 utilizing neuraxial anesthesia and the others with general anesthesia. A 30-day postoperative course of low-molecular-weight heparin was prescribed, and all patients subsequently had vaginal deliveries. Femoral fractures in the viable pregnancy confer high maternal and fetal morbidity and mortality. Intraoperative fetal monitoring and postoperative anticoagulation should be considered, and vaginal delivery should not be contraindicated.Keywords: femoral fracture, antepartum testing, trauma in pregnancy, venous thromboembolism prevention, osteoporosis in pregnancy

Keywords

• femoral fracture
• antepartum testing
• trauma in pregnancy
• venous thromboembolism prevention
• osteoporosis in pregnancy