Minor trauma in pregnancy--is the evaluation unwarranted?

The purpose of this study was to examine the rate of and risks for abruption and adverse pregnancy outcome after minor trauma in pregnancy.

This is a 3-year prospective cohort study of patients after noncatastrophic trauma. Data collected included maternal demographics and history, trauma mechanism, and pregnancy outcome. Examination, lab tests including Kleihauer-Betke (KB), and a minimum of 4 hours of fetal monitoring were performed. The primary outcomes were placental abruption and a composite pregnancy morbidity outcome. Univariate and bivariate analysis were performed.

Of the 317 patients evaluated for minor trauma, 9 had a positive KB test (2.8%). Delivery information was available on 256 (81%) patients, and there was 1 placental abruption. The 49 cases (19.4%) of composite outcome could not be predicted.

Perhaps it is time to reevaluate the extensive evaluations often done after minor trauma in pregnancy, particularly because none of the commonly used objective measures are predictive of adverse outcomes.