Pregnancy outcome and fetomaternal hemorrhage after noncatastrophic trauma.
Two hundred five consecutive cases of noncatastrophic trauma occurring during the second half of pregnancy were evaluated prospectively. Pregnancy complications as a result of trauma occurred in 18 of 205 patients (8.8%): premature labor (n = 10), placental separation (n = 5), fetal injury (n = 1), and fetal death (n = 2). Multiple regression analysis of the data base showed obstetric findings (contractions, uterine tenderness, and bleeding) on presentation to be highly associated with complications (17/88; 19.3%). In their absence complications were rare (1/117; 0.9%). Detectable fetomaternal hemorrhage was significantly more common in trauma patients (18/205) than in control subjects (2/110) (p less than 0.01), but its role in managing trauma patients was limited to detection of rare massive hemorrhage (1/205) and detection of rare hemorrhage exceeding that covered by the standard Rho (D) immune globulin dose (2/205). Fetomaternal hemorrhage need not be quantitated in patients who lack obstetric findings on presentation. Despite rare reports of delayed abruptio placentae, it is doubtful that prolonged observation (greater than 2 to 3 hours) in the hospital is necessary in patients who lack obstetric findings on initial presentation.
Goodwin
T M
TM
Department of Obstetrics and Gynecology, Maricopa Medical Center, Phoenix, Arizona.
Breen
M T
MT
D000063:Accidents, Traffic; D000293:Adolescent; D000328:Adult; D005260:Female; D005331:Fetomaternal Transfusion / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology / Q000209:etiology; D011256:Pregnancy Outcome; D013179:Spouse Abuse; D014947:Wounds and Injuries / Q000150:complications*