Trauma in Pregnancy: A Systematic Approach

Abstract

Trauma in pregnancy remains one of the major contributors to maternal and fetal morbidity and mortality. Potential complications include maternal injury or death, shock, internal hemorrhage, intrauterine fetal demise, direct fetal injury, abruptio placentae, and uterine rupture. The leading causes of obstetric trauma are motor vehicle accidents, falls, assaults, and gunshots, and ensuing injuries are classified as blunt abdominal trauma, pelvic fractures, or penetrating trauma. Many of the assessment and management aspects of obstetric trauma are unique to pregnancy, although initial evaluation and resuscitation should always be maternally directed. Once maternal stability is established, vigilant evaluation of fetal well-being becomes warranted. Continuous fetal heart monitoring, ultrasonography, computed tomography, open peritoneal lavage, and/or exploratory laparotomy may be indicated in a case of obstetric trauma. In view of the significant impact of trauma on the pregnant woman and her fetus, preventive strategies are paramount.

Trauma in Pregnancy at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso: Epidemiological, Clinical, Therapeutic and Prognostic Aspect

“… Circumstances of injury In our study, the circumstances of the injury were dominated by road traffic accident in 82.6% of cases; falls in 9.8% and assaults in 7.6% of cases. Some authors have reported a predominance of road traffic accidents with frequencies between 49% and 74.3% [2] [6] [7]. The high frequency of road traffic accidents in Traore et al and our series, respectively 74.3% and 82.6% could be related to lack of strict implementation of the road traffic regulations.…”

“…In the pelvic fractures, the risk of fetal injury is more important if the presentation is cephalic and fixed. A pelvic fracture is not a definite contraindication for vaginal delivery even in the presence of a slightly displaced pelvic fracture [2] [10]. Abdominal contusions were mostly observed during road traffic accidents involving motorcycles and during assaults.…”

“…It's the leading cause of death none related to pregnancy [1] [2]. The consequence of these injuries varies according to the term of gestation and the mechanism of occurrence [3].…”

“…The management of a pregnant woman victim of trauma is delicate and must be multidisciplinary, including obstetricians, intensive care specialists, surgeons and pediatricians [2] [4]. In the absence of previous studies on trauma during pregnancy in Burkina Faso, we propose to describe the epidemiological, clinical, prognostic and therapeutic pattern of these injuries during pregnancy at the Yalgado Ouedraogo Teaching Hospital in Ouagadougou, Burkina Faso.…”

Perioperative considerations for neurosurgical procedures in the gravid patient: Continuing Professional Development

“…Head injury is especially devastating and can increase the overall morbidity and mortality. 10 Motor vehicle accidents are the commonest cause of head injury in pregnant patients. Importantly, significant trauma is associated with higher chances of fetal mortality when compared with maternal deaths.…”