Emir Battaloglu1, Declan McDonnell2, Justin Chu3, Fiona Lecky4, Keith Porter5. 1. Trauma & Orthopaedics Specialist Registrar, University Hospitals Birmingham, Birmingham, United Kingdom. Electronic address: e.battaloglu@nhs.net. 2. Core Surgical Trainee Year One, University Hospital Southampton, Southampton, United Kingdom. 3. Obstetrics & Gynaecology Specialist Registrar and Clinical Research Fellow, Birmingham Women's Hospital, Birmingham, United Kingdom. 4. Trauma Audit Research Network, Salford, United Kingdom. 5. Clinical Traumatology and Trauma & Orthopaedics Consultant Surgeon, University Hospitals Birmingham, Birmingham, United Kingdom.
Abstract
OBJECTIVE: To understand the epidemiology of pregnancy and obstetric complications encountered in the management of pregnant trauma patients. METHODS AND DESIGN: Retrospective analysis of national trauma registry for recording of pregnancy status or obstetric complication in cases of trauma. Sub-division of patient cohort by severity of trauma and stage of pregnancy. Comparison of data sets between pregnant trauma patients and age-matched non-pregnant female trauma patients to determine patterns of injury and impact upon clinical outcomes. SETTINGS: National registry data for the United Kingdom. OUTCOME: For the five year period between 2009 and 2014, a total of 15,140 female patients, aged between 15 years old and 50 years old were identified within the trauma registry. A record of pregnancy was identified in 173 patients (1.14%) from within this cohort. Mechanisms of injury within the cohort of pregnant trauma patients saw increased rate of vehicular collision and interpersonal violence, especially penetrating trauma. Higher abbreviated injury scores were recorded for the abdominal region in pregnancy than in the non-pregnant cohort. Maternal mortality rates were seen to be higher, when compared with the non-pregnant trauma patient. Foetal survival rate from this series was 56% following trauma. Foetal death in pregnant trauma patients most frequently occurred in the 2nd trimester. No cases of isolated foetal survival were recorded following maternal trauma. CONCLUSIONS: Trauma to pregnant patients is rare in the United Kingdom, encountered in 1% of female trauma patients of child bearing age. Observations in altered mechanisms of injury and clinical outcomes were recorded. This provides useful information regarding the clinical management of pregnant trauma patients and offers potential areas to investigate to optimise their care, as well as to focus injury prevention measures. LEVEL OF EVIDENCE: IV--Case series.
OBJECTIVE: To understand the epidemiology of pregnancy and obstetric complications encountered in the management of pregnant traumapatients. METHODS AND DESIGN: Retrospective analysis of national trauma registry for recording of pregnancy status or obstetric complication in cases of trauma. Sub-division of patient cohort by severity of trauma and stage of pregnancy. Comparison of data sets between pregnant traumapatients and age-matched non-pregnant female traumapatients to determine patterns of injury and impact upon clinical outcomes. SETTINGS: National registry data for the United Kingdom. OUTCOME: For the five year period between 2009 and 2014, a total of 15,140 female patients, aged between 15 years old and 50 years old were identified within the trauma registry. A record of pregnancy was identified in 173 patients (1.14%) from within this cohort. Mechanisms of injury within the cohort of pregnant traumapatients saw increased rate of vehicular collision and interpersonal violence, especially penetrating trauma. Higher abbreviated injury scores were recorded for the abdominal region in pregnancy than in the non-pregnant cohort. Maternal mortality rates were seen to be higher, when compared with the non-pregnant traumapatient. Foetal survival rate from this series was 56% following trauma. Foetal death in pregnant traumapatients most frequently occurred in the 2nd trimester. No cases of isolated foetal survival were recorded following maternal trauma. CONCLUSIONS:Trauma to pregnant patients is rare in the United Kingdom, encountered in 1% of female traumapatients of child bearing age. Observations in altered mechanisms of injury and clinical outcomes were recorded. This provides useful information regarding the clinical management of pregnant traumapatients and offers potential areas to investigate to optimise their care, as well as to focus injury prevention measures. LEVEL OF EVIDENCE: IV--Case series.
Authors: Bryan G Maxwell; Andrea Greenlaw; Wendy J Smith; Ronald R Barbosa; Kate M Ropp; Megan R Lundeberg Journal: Womens Health (Lond) Date: 2020 Jan-Dec
Authors: Ryan J Keneally; Kyle L Cyr; Marian Sherman; Anita Vincent; Everett Chu; Jeffrey S Berger; Jonathan H Chow Journal: J Emerg Trauma Shock Date: 2021-12-24