title: Trauma in pregnant women: analysis of maternal and fetal mortality.
abstract: Twenty-seven traumatised pregnant women were analysed retrospectively over a period of 9 years. Mean age was 23.7 years (16-42 years). Gestational age ranged from 10 to 40 weeks (mean, 21.5 weeks), with most victims (46.1%) being in the second trimester. The predominant mechanism (65.3%) was blunt abdominal injury due to an automobile accident (the patient being run over or collision). At admission, 8 (30.7%) patients had haemodynamic alterations. 6 patients (23.0%) presented vaginal bleeding and 4 of these were haemodynamically normal. We analysed maternal mortality, fetal mortality and their causes. We also compared the median RTS and TRISS values for the groups with maternal-fetal survival and the group with maternal-fetal death. Fetal death occurred in all pregnant women admitted with vaginal bleeding. Maternal mortality due to haemorrhagic shock was 11.5%. Fetal mortality was 30.7%, with 37.5% of these deaths being caused by maternal death. The major cause of fetal mortality was a detached placenta (50.0%). The trauma indices, RTS and TRISS, were significantly lower (p = 0.0025 and p < 0.0001) in the group of maternal-fetal death but they were not of prognostic value in terms of fetal mortality.
authors.affiliation: Surgery Department of Santa Casa of São Paulo School of Medicine, Brazil. corsi@netpoint.com.br
authors.forename: P R
authors.initials: PR
authors.lastname: Corsi
authors.forename: S
authors.initials: S
authors.lastname: Rasslan
authors.forename: L B
authors.initials: LB
authors.lastname: de Oliveira
authors.forename: F S
authors.initials: FS
authors.lastname: Kronfly
authors.forename: V P
authors.initials: VP
authors.lastname: Marinho
mesh_terms: D000293:Adolescent; D000328:Adult; D001938:Brazil / Q000453:epidemiology; D002423:Cause of Death; D005260:Female; D005313:Fetal Death / Q000453:epidemiology*; D006801:Humans; D008428:Maternal Mortality; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D015599:Trauma Severity Indices; D014947:Wounds and Injuries / Q000401:mortality*