Abdominal injuries in pregnancy: a 155-month study at two level 1 trauma centers

Petrone, Patrizio; Talving, Peep; Browder, Timothy; Teixeira, Pedro G.R.; Fisher, Orna; Lozornio, Alfredo; Chan, Linda S.

doi:10.1016/j.injury.2010.06.026

Cited by 155 publications

(72 citation statements)

References 20 publications

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“…1,2 Between 5% and 7% of all pregnancies are complicated by injuries, and trauma in pregnancy remains a common cause of fetal death. [2][3][4] In a retrospective review of US fetal-death certificates, Weiss et al 4 estimated that 5.4 per 1,000 fetal deaths were owing to maternal injury.…”

Section: Introductionmentioning

confidence: 99%

Risk Factors for Maternal Injuries in a Population-Based Sample of Pregnant Women

Harland

Saftlas

Yankowitz

et al. 2014

Journal of Women's Health

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Background: The prevalence of injuries during pregnancy is largely underestimated, as previous research has focused on more severe injuries resulting in emergency department visits and hospitalizations. The objective of our study was to estimate the frequency, risk factors, and causes of injuries in a population-based sample of pregnant women. Methods: This article is an analysis of postpartum interviews among the control series from a case-control study (n = 1,488). Maternal, pregnancy, and environmental characteristics associated with injury during pregnancy in control subjects were examined to identify population-based risk factors for injury. We collected data on selfreported injury during pregnancy, including the month of pregnancy, whether medical attention was sought, the mechanism of injury, and the number and location of bodily injuries. Logistic regression was used to calculate unadjusted and adjusted odds ratios (aORs) of injury. Results: Over 5% of women reported an injury during pregnancy, with falls being the most common mechanism of injury. Women at highest adjusted risk for injury had unintended pregnancies (aOR: 2.28 [1. 40-3.70]) and no partner during pregnancy (aOR: 2.45 [1. 16-5.17]) relative to women without injuries. Conclusions: Pregnant women with risk factors for many pregnancy-related complications are also at increased risk of injury during pregnancy. Further studies of pregnancy-related injuries are needed to consider environmental and maternal characteristics on risk of injury.

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Section: Introductionmentioning

confidence: 99%

Risk Factors for Maternal Injuries in a Population-Based Sample of Pregnant Women

Harland

Saftlas

Yankowitz

et al. 2014

Journal of Women's Health

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“…The results in the fetus are generally worrisome, causing direct impact up to 60-90%. In these cases maternal mortality is around 7-9% while fetal mortality is approximately 70% [7,11]. In our case, the uterus was in supraumbilical level and had absorbed the piece of bullet, therefore, other intraabdominal organs had remained intact.…”

Section: Discussionmentioning

confidence: 63%

“…Of those, 73% was gunshot wounds, 23% stab wounds and 4% shotgun-related. Penetrating trauma in pregnancy was associated with a maternal mortality of 3.9-7% and with an increased fetal mortality (as high as 73%) [7]. Gunshot wounds to the abdomen during pregnancy are becoming increasingly common.…”

Section: Discussionmentioning

confidence: 99%

Abruptio Placenta Caused by Gunshot Injury in Second Trimester: A Case Report

2016

Ann Clin Anal Med

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ÖzetYirmi dokuz yaşında multigravid bir gebe ateşli silah yaralanması nedeniyle kliniğimize başvurdu. Anamnezde 24 haftalık gebeliği mevcuttu. Yapılan ultrason muayenesinde retroplasental yaklaşık 6 cm lik hipoekoik bir alan ve bu bölgeye yakın yaklaşık 1 cm lik hiperekojen odak izlendi. Yine batın inspeksiyonunda umbilikusun 2 cm altında kanayan bir kesi alanı izlendi. Dekolman plasenta tanısıyla acil cerrahi düşündük. Ameliyat esnasında plasentanın % 50 dekole olduğu ve plasenta ile myometrium arasında bir mermi parçası olduğunu gördük. Mermi parçasını çıkar-tıp uterusun perfore alanı ve sezaryen kesi alanını tamir ettik. Ateşli silah yaralanmasının anne ve fetusu etkilemeksizin sadece abrusyo plasentaya yol açması nedeniyle bu vakanın önemli olduğunu düşündük. Anahtar KelimelerAteşli Silah; Gebe; Uterus Abstract A twenty-nine year old, multigravida woman was admitted to our clinic due to a gunshot injury. She had 24 weeks of gestation. It was observed by ultrasonography that there were 6 cm hypoechogenic image retroplacentally located and 1 cm hyperechogenic focus near to this image, and there was also a 2 cm actively bleeding incision area in subumbilical region by inspection of abdomen. We decided emergent operation because of the diagnosis of abruptio placenta. During the operation, we observed a piece of bullet between the placenta and myometrium and 50% separation of the placenta. We removed the piece of bullet, repaired the uterine perforation and then performed a caesarean section. We considered that this case is important because a gunshot injury had only caused an abruptio placenta without affecting mother and her fetus seriously.

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“…Petrone et al [22] investigated the abdominal trauma in pregnancy with a larger population than our study. They stated that the penetrating trauma to abdomen has higher maternal and fetal mortality than blunt trauma (7% vs 2%).…”

Section: Discussionmentioning

confidence: 84%

Maternal and Fetal Outcomes of 179 Traumatised Pregnants in Teritary Referral Center

Alkış¹,

Karadaş²,

Karaman³

et al. 2014

OJOG

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Objective: The aim of this study was to evaluate the clinical characteristics, maternal and fetal outcomes of trauma in pregnants. Methods: This is a retrospective analysis of all traumatised pregnants who admitted to Yüzüncü Yıl University teritary referral hospital from June 2010 and December 2012. One hundred seventy-nine pregnants in whom referred for trauma analysed for the data about mechanism of trauma, demographic and obstetric parameters on admission, diagnostic and surgical procedures performed, maternal and fetal outcomes. The SAS statistical package version 9.2 was used in data analysis. Results: Overall, the medical records of 179 patients were reached and included in the study. The mean age was 27.5 ± 5.8. Gestational age ranged from 6 to 39 weeks (mean, 26.2 weeks), with most trauma (49.1%) being in the third trimester. Road trrafic accident (RTA) was the main mechanism of trauma (41.5%) followed by falls (26.4%). Trauma due to animal recoil was seen in three patients. The most injured body area was extremity (34.2%). Traumatised pregnants resulted in metarnal (4 cases) and fetal (16 cases) loss. Most of the fetal loss (49.1%) was seen third trimester, with the main cause detected as placental abruption (8 cases). When compared the complicated pregnancy according to trauma site, abdominal trauma (33.3%) was significantly related to complication in pregnancy than non-abdominal trauma (21.9%) (p = 0.014). Conclusions: Trauma in pregnancy carries risks for both mother and baby. Trauma to abdominal region and trauma in second or third trimester pregnancy is associated with significantly higher maternal and fetal complications.

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Abdominal injuries in pregnancy: a 155-month study at two level 1 trauma centers

Cited by 155 publications

References 20 publications

Risk Factors for Maternal Injuries in a Population-Based Sample of Pregnant Women

Risk Factors for Maternal Injuries in a Population-Based Sample of Pregnant Women

Abruptio Placenta Caused by Gunshot Injury in Second Trimester: A Case Report

Maternal and Fetal Outcomes of 179 Traumatised Pregnants in Teritary Referral Center

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