# Assessing the Effects and Challenges of Total Hip Arthroplasty before Pregnancy and Childbirth: A Systematic Review

## TL;DR

This review explores the effects of hip replacement surgery on pregnancy and childbirth, finding that it is generally safe but more research is needed.

## Contribution

The paper provides a systematic review of the limited literature on hip arthroplasty and pregnancy outcomes.

## Key findings

- Women with hip implants have higher c-section rates but vaginal delivery is possible with precautions.
- Hip implants are well-tolerated during pregnancy and gestation does not affect implant survival.
- Metal ions from implants do not cause significant complications for mothers or offspring.

## Abstract

Total hip arthroplasty is indubitably one of the most performed operations worldwide. On the other hand, especially in the western world, the average age that women get pregnant has raised confoundedly. Consequently, a steadily increasing number of women become pregnant after they had hip arthroplasty surgery, with copious potential implications. The amount of knowledge on this particular field is considered inadequate in the existing literature. This paper aims to augment clinicians understanding surrounding this topic. A systematic literature review was conducted in accordance with the PRISMA guidelines. Papers from various computerized databases were scrutinized. Article selection was carried out by three authors independently employing specific pre-determined inclusion and exclusion criteria, while disagreements were elucidated with the contribution of other authors. A patently limited number of research articles were detected from our rigorous literature review, with only 12 papers meeting the inclusion criteria. The vast majority of studies were small-scale and examined confined population groups. Most studies had been performed in Finland, utilizing data from nationwide registries. Women with previous history of total hip arthroplasty feature increased rates of c-section delivery, although vaginal labor can be attempted with certain precautions. Hip implants’ survival does not appear to be affected from gestation, which is predominately well-tolerated from these women. Metal ion circulation in mothers’ blood has not been proven to trigger substantial complications concerning either mothers or offspring. It can be considered safe for women with such medical history to get pregnant; however, further multinational studies and pertinent research on this field are vital to attain more solid inferences.