Vaginal delivery OK after total hip replacement – Studies Show Low RiskVaginal delivery is feasible for women who have undergone total hip replacement, according to data from two studies presented at the annual meeting of the American Academy of Orthopaedic Surgeons.One study, presented by Dr. Rafael J. Sierra of the Mayo Clinic, Rochester, Minn., retrospectively reviewed 343 women aged 18-45 years who had primary total hip replacements between 1975 and 1995. A total of 57 of these women together had 108 pregnancies after hip replacements during the study period. The babies were delivered by cesarean section in 20 patients and vaginally in 31 patients; the delivery method was unknown for the remaining 6 patients. Of the 57 women who became pregnant after total hip replacement, 8 (14%) noted increased hip pain during pregnancy and approximately half of these reported persistent hip pain post pregnancy.The risk of hip revision surgery after pregnancy and childbirth was not significantly different among patients after adjusting for age, but revision risk was 17 times higher in women who have had at least one child, after total hip replacement when not adjusted for age. The mean time from total hip replacement to first successful pregnancy was 3;8 years, ranging from 7 months to 10.7 years.In a second study–a retrospective look at a single surgeon’s practice from 1981 to 2000–12% of 109 women aged 45 years and younger had a least one successful pregnancy an average of 3 years after total hip replacement. Pregnancy-related complications were not increased as a result of hip replacement, nor were revision rates significantly increased, said Dr. Russell Meldrum of Indiana University Indianapolis.Of 20 pregnancies reported by 13 patients, 11 babies were delivered vaginally 5 by planned cesarean section, 3. by unplanned cesarean section, and I was terminated due to feral lung malformation. No complications were related to the presence of a hip implant. However, since younger patients who undergo total hip replacement may have other significant health problems, the researchers recommended medical clearance for hip replacement patients before pregnancy.