Facial fracture in pregnancy: Case report and review

Aramanadka, Chithra; Gadicherla, Srikanth; Shukla, Anand Deep; Kudva, Adarsh

doi:10.4103/jioh.jioh_263_17

Cited by 5 publications

(5 citation statements)

References 12 publications

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“…Procedures performed include appendectomy, cholecystectomy, adnexal repair, and trauma repair. The reported postoperative complication rate during pregnancy is 5.8%, with the most feared complication being preterm delivery 9,10 . Despite the inherent risk, emergency procedures for life-saving measures should be pursued regardless of pregnancy stage.…”

Section: Discussionmentioning

confidence: 99%

Management of Maxillofacial Trauma in Pregnant Women

Taylor,

Jabori,

Kim

et al. 2024

Journal of Craniofacial Surgery

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Introduction: Trauma during pregnancy deserves special attention as management must be directed towards both the mother and the fetus. Management of maxillofacial fractures in pregnancy can adversely affect the well-being of the fetus by impinging on normal functions such as respiration, mastication, and nutrition. Pregnancy complicates the management of facial injury due to the maintenance of the patent airway, anesthesia considerations, and imaging restraints. The purpose of this study is to use three illustrative from our own institution to further elucidate education on the management of mandible fracture in pregnancy with a focus on multidisciplinary treatment and outcomes. Methods: A retrospective chart review was performed for all cases of facial fractures admitted to Ryder Trauma Center from 2012 to 2022. During this time, 4,910 patients presented with facial fractures 1319 patients were female. Three of the patients were pregnant at the time of admission. Demographics, mechanism of injury, associated injuries, and management information were collected. Results: Patient 1 was a 20-year-old female presented to Ryder Trauma Center following a motor vehicle collision. She was 17 weeks pregnant at the time of admission and was found to have a left mandibular angle fracture. Patient 2 was a 14-year-old female who presented to Ryder Trauma Center status post gunshot wound to the mandible after she and her brother were unknowingly playing with a loaded gun. She was 18 weeks pregnant at the time of admission, with a past medical history of domestic violence, suicidal ideation, and major depressive disorder. Patient 3 was a 20-year-old female 36 weeks pregnant at the time of admission. She presented with a right paraymphyseal fracture and left mandibular angle fracture as a result of falling on the stairs. Patients all underwent surgical repair of fractures.

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Section: Discussionmentioning

confidence: 99%

Management of Maxillofacial Trauma in Pregnant Women

Taylor,

Jabori,

Kim

et al. 2024

Journal of Craniofacial Surgery

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“…A commonly encountered challenge is the maintenance of a patent airway due to physiological alterations in the superior airway. Increased blood volume and hormonal changes may contribute to laryngeal edema and friability, which leads to difficulties in laryngoscopy and intubation 10 . Alterations in gestational maternal respiration include increased oxygen consumption (20%), increased minute ventilation (50%), and decreased functional residual capacity (20%).…”

Section: Discussionmentioning

confidence: 99%

“…These result in rapid oxygen desaturation and apnea. During tidal ventilation, partial airway closure may occur and this can result in increased ventilation and maternal hypoxia due to perfusion mismatch 10 . Thus, general anesthesia is generally not preferred in the first or third trimester of pregnancy considering the potential fetal injuries due to anesthetic anoxia as well as the risk of abortion and teratogenicity due to the drugs used.…”

Section: Discussionmentioning

confidence: 99%

Maxillofacial injuries in pregnancy following domestic abuse: A challenge in management

Agarwal

Chug

Bhatt³

et al. 2020

Dental Traumatology

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Domestic violence against women remains one of the most difficult obstacles in the growth of civilization. The maxillofacial region is commonly involved, and injuries are complex to characterize and manage due to diverse presentations, underlying physiological changes and sometimes an association with pregnancy complications, creating a challenge for the operating surgeon. This case report discusses the clinical presentation of maxillofacial injuries sustained by a pregnant woman who also had obstetric complications. The management of such trauma by a multidisciplinary squad led by the maxillofacial surgery team is outlined. Increasing awareness among oral healthcare providers for the early identification of interpersonal abuse along with timely intervention and adequate referral is important. Close monitoring and follow-up are also mandatory.

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“…According to Dr Frederick C. Irving upto 2% of pregnant women undergo surgery for non-obstetric conditions each year (10). The main risks of surgery during pregnancy are foetal loss, premature labour and delivery (1,4). Nitrous oxide also causes vasoconstriction and may reduce uterine blood supply, decreased fertility and spontaneous abortion in women (2).…”

Section: Discussionmentioning

confidence: 99%

“…Intubation can be difficult in pregnancy as there is a risk of epistaxis due to friable mucous membrane (5). Supine position should be avoided, and lateral decubitus position is preferable (1). Thiopental and propofol are safe induction agents (5).…”

Section: Discussionmentioning

confidence: 99%