Trauma during pregnancy. A review of 79 cases.
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.
Department of Surgery, Maryland Institute for Emergency Medical Services Systems, Baltimore.
T J
TJ
Esposito
D R
DR
Gens
L G
LG
Smith
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R
Scorpio
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T
Buchman
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D005260:Female; D005316:Fetal Distress / Q000453:epidemiology; D006801:Humans; D000860:Hypoxia / Q000453:epidemiology; D015601:Injury Severity Score; D008396:Maryland / Q000453:epidemiology; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology; D011256:Pregnancy Outcome; D015995:Prevalence; D012189:Retrospective Studies; D012622:Seat Belts / Q000706:statistics & numerical data; D012769:Shock / Q000453:epidemiology; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000453:epidemiology