Pregnancy After Amputation: A Systematic Review of Pregnancy Experiences for Women With Lower Extremity Amputations.

Pregnancy could affect the mobility of women with lower extremity limb loss, deficiency, or amputations. The aim of this systematic review was to characterize the pregnancy-related experiences, including prosthesis, gait aid, and mobility outcomes, of women with lower extremity limb loss, deficiency, or amputations. MEDLINE, CINAHL, and Embase databases were searched for all relevant English-language articles describing pregnancy experiences of women with lower extremity limb loss, deficiency, or amputations. Data extracted were age, amputation level and etiology, obstetrical history, prosthesis and/or gait aid use before, during, and after pregnancy, and pregnancy-related complications. Risk of bias was assessed using applicable CLARITY tools. Data were analyzed with descriptive statistics. Among 399 retrieved studies, 24 met inclusion criteria describing 31 pregnancies in 25 women. All were case series/reports with high risk of bias. All women had acquired lower extremity limb loss, deficiency, or amputations. Sixteen women had hemipelvectomy (64%) and 4 had transfemoral amputations (16%). Three women used a prosthesis, 5 did not, and use was not described for 17 (68%). Prosthesis or gait aid use changed in 2 pregnancies, did not change in 6, and was not specified in 23 (74%). Available cases are likely not representative; additional research is required to characterize the impact of pregnancy on women with lower extremity limb loss, deficiency, or amputations.