title: Elevated maternal serum α-fetoprotein after minor trauma during pregnancy may predict adverse fetal outcomes.
abstract: BACKGROUND
  We evaluated the relationship between minor trauma during pregnancy and elevated maternal serum α-fetoprotein level.
  
  
  METHODS
  This is a retrospective review of pregnant patients admitted to Fukui Prefectural Hospital with trauma during a 10-year period. Charts were reviewed for maternal age, gestational age, injury characteristics, Injury Severity Score, the presence of abdominal pain, systolic pressure and heart rate on arrival, fetal hemoglobin level, and maternal serum α-fetoprotein (MSAFP) concentration on arrival.
  
  
  RESULTS
  Fifty-one pregnant patients with any trauma were treated at Fukui Prefectural Hospital. All patients were hemodynamically stable and had minor trauma. An adverse pregnancy outcome occurred in three patients (5%). One patient's fetus had a left kidney injury. Intrauterine fetal death occurred in two patients. The time from injury to fatal death was 180 minutes in one patient and 18 hours in the other patient. The mean ± SD fetal hemoglobin was 0.57% ± 0.88%. The mean ± SD MSAFP was 511 ng/mL ± 1,263 ng/mL. Three patients with adverse pregnancy outcome had a high MSAFP of greater than 1,000 ng/mL.
  
  
  CONCLUSIONS
  High level of MSAFP may be a predictor of poor fetal outcome following trauma during pregnancy regardless of the severity of the trauma or the mother's hemodynamic status.
  
  
  METHODS
  Epidemiologic study, level V.
authors.affiliation: From the Department of Emergency Medicine, Fukui Prefectural Hospital, Fukui, Japan.
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Tanizaki
authors.forename: Shigenobu
authors.initials: S
authors.lastname: Maeda
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Matano
authors.forename: Makoto
authors.initials: M
authors.lastname: Sera
authors.forename: Hideya
authors.initials: H
authors.lastname: Nagai
authors.forename: Shotaro
authors.initials: S
authors.lastname: Kawamura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ishida
mesh_terms: D000328:Adult; D005260:Female; D005313:Fetal Death / Q000209:etiology; D006801:Humans; D015601:Injury Severity Score; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood*; D011256:Pregnancy Outcome; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000097:blood* / Q000150:complications; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins