Trauma During Pregnancy

Abstract

Few studies provide data on pregnant trauma patients that can be used to direct management decisions. Therefore, this retrospective study of 79 pregnant patients who were injured and admitted to a trauma center during a 9-year period was conducted to obtain such information. Maternal mortality for these pregnant patients was 10%, which was not different from that for nonpregnant females. Overall, rate of fetal loss was 34%. Rates of fetal loss were not different in patients with and without evidence of shock and/or hypoxia or in restrained and unrestrained automobile occupants. Diagnostic peritoneal lavage proved to be 95% accurate and safe. Based on these findings, we concluded the following: pregnancy does not increase maternal mortality from trauma. Blood pressure, pulse rate, and PO2 are unreliable indicators of adequate maternal resuscitation and fetal well-being. Assumption of maternal and fetal stability based solely on these usually standard criteria is unwise. Use of seat belts during pregnancy is advisable in the absence of evidence that restraints increase the rate of fetal loss.

Pregnancy and trauma: analysis of 139 cases

“…The most common causes of trauma were reported as motor vehicle accidents (55%), falls (23%), assaults (21%) and burns (1%) (10,11). The period when trauma is seen most frequently was the 3 rd trimester in this study also, as in that of El-Kady et al Trauma etiologies were detected as falls during daily activities rd trimesters may be the displacing of the center of gravity due to weight gain and enlargement of the uterus.…”

“…Stafford (22) and Baed et al (3) reported that the degree of maternal injury was not an important factor for permanent fetal injury and the ratio of trauma-related fetal losses was higher than the ratio of maternal deaths. Shah et al (23) reported the maternal death rate as 3.5%, Esposito et al (10) reported fetal death rate as at least 5%. In this study, while the ratio of fetal losses was 6.5%, maternal death rate was 2.2% and fetal losses were more than maternal deaths.…”

Traumatismo encefalocraneano fetal por vía penetrante transvaginal

“…4 Se estima que la incidencia de traumatismos durante el embarazo podría alcanzar el 7% y según los más recientes estudios epidemiológicos su frecuencia ha aumentado en las últimas dos décadas. 5,6 La mayoría de las lesiones fetales se producen en el tercer trimestre de la gestación, probablemente como consecuencia de la mayor exposición del feto a heridas abdominales a medida que aumenta la edad gestacional y de que la mayor superficie corporal fetal se ubica por fuera de la cavidad pélvica verdadera. 2 Una revisión realizada por Harold y cols., revela que los mecanismos de trauma más frecuentemente relacionados con mortalidad fetal son, en orden descendente de frecuencia, los accidentes de tránsito, las heridas por proyectil de arma de fuego y las caídas; mientras que las ocasionadas por armas cortopunzantes son muy raras.…”

Gebelikte Travma Yönetimi

“…Perhaps more importantly, uteropelvic blood flow increases markedly during pregnancy. By the end of pregnancy, this dramatic increase in pelvic blood flow increases the likelihood of appreciable hemorrhage in the event of uterine injury or pelvic trauma (13). Maternal death takes place in 10% of cases of traumatic uterine rupture,but the majority of fetal deaths occur with uterine rupture (19).…”

“…Maternal death rates from trauma may be noted as high as 10% to 11% (12,13). In traumatic injuries the rate of fetus death is higher than death of the mother.…”