Evaluation of pregnant women after blunt injury.
A retrospective review of 125 pregnant women with blunt injuries admitted to a level I trauma center over a 35-month period was performed. The usefulness of three diagnostic tests, fetal ultrasound (US), external fetal monitoring (EFM), and Kleihauer-Betke (KB) tests in detecting fetal or pregnancy-associated complications was evaluated. The majority of women (77.6%) were involved in motor vehicle crashes and the mean injury Severity Score was low (4.7). The most common complications were premature uterine contractions (67%) and abruptio placentae (11%). When used together, EFM and US identified all complications. Moreover, all complications were manifest within 6 hours of admission. The KB tests had a sensitivity of 56%, a specificity of 71%, and an accuracy of 27%. We conclude that EFM and US are more useful in detecting fetal or pregnancy-associated complications after blunt injury. Monitoring can be limited to 6 hours if previous monitoring is normal. The KB test is of little use in the setting of acute trauma.
Towery
R
R
Department of Surgery, University of California, Davis, Sacramento 95817.
English
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TP
Wisner
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D000037:Abruptio Placentae / Q000209:etiology; D000063:Accidents, Traffic; D005260:Female; D005323:Fetal Monitoring; D005331:Fetomaternal Transfusion / Q000175:diagnosis; D006801:Humans; D007752:Obstetric Labor, Premature / Q000209:etiology; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D015599:Trauma Severity Indices; D014463:Ultrasonography; D014599:Uterus / Q000000981:diagnostic imaging; D014949:Wounds, Nonpenetrating / Q000150:complications*