Normal childbirth is a frequent concern for women who have had surgery for hip dysplasia. Fortunately, the need for Cesearean section is rarely influenced by hip dysplasia or hip dysplasia surgery.
Your obstetrician can measure the size of the pelvis prior to childbirth to help determine possible need for Cesearean section. Sometimes hip motion is restricted and this can lead to Cesearean section if the hip doesn’t have enough movement to allow normal childbirth.
Hip dysplasia by itself is not associated with increased difficulty with normal delivery. With hip dysplasia the socket itself is shallow, but the internal borders of the pelvis have normal size and shape. HIp surgery during childhood rarely causes problems with pregnancy later in life. Surgery like open reduction, or femoral osteotomy would not change the shape of the pelvis and the pelvis is normal size and shape for most women with hip dysplasia.
Even pelvic surgery during childhood has so much remodeling capacity that any surgery prior to the age of six years should smooth out and accommodate normal pregnancy and childbirth. When pelvic surgery has been performed after the age of six years, the pelvic bones can become slilghtly distorted and cause problems with childbirth. In these cases it may be helpful to know what kind of surgery was performed on the pelvis. The Ganz Osteotomy (also called the PAO) is a commonly performed bone surgery in adolescents and adults with painful hip dysplasia. The PAO does not restrict pelvic diameter. The less common types of pelvic surgery that might cause concern are the Steel, Chiari, Sutherland, and Salter osteotomies when these have been performed on both hips or after the age of six years. The Salter, Dega, and others are used in young children and shouldn’t be problematic.
In summary, it is very uncommon for hip dysplasia or hip dysplasia surgery to be a problem for delivery. Of course, your obstetrician will help you decide whether you might need to plan for a Cesearean section after you become pregnant. Also, we know you will remember to have the pediatrician double-check your child because there is a slightly increased risk that your children may have loose hips that can become dysplastic.
