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Trauma and pregnancy

A M Connolly1, V L Katz, K L Bash

  • 1Department of Obstetrics and Gynecology, University of North Carolina at Chapel Hill, USA.

American Journal of Perinatology
|July 1, 1997
PubMed
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Trauma in pregnancy affects 6-7% of cases. This study found that normal fetal monitoring and absence of warning signs after trauma predict good outcomes, recommending a 4-hour monitoring protocol.

Area of Science:

  • Obstetrics and Gynecology
  • Trauma Surgery
  • Maternal-Fetal Medicine

Background:

  • Trauma complicates 6-7% of pregnancies, with management often based on limited data.
  • Existing protocols for pregnant trauma patients lack robust empirical support.
  • Tertiary care centers and community hospitals manage diverse pregnant trauma populations.

Purpose of the Study:

  • To characterize demographics of pregnant trauma patients.
  • To identify predictors of fetal outcomes, including Kleihauer-Betke tests and nonstress testing.
  • To propose an evidence-based evaluation and management protocol for trauma in pregnancy.

Main Methods:

  • Retrospective review of 476 pregnant trauma cases from July 1987 to October 1993.
  • Statistical analysis using Chi-square and Kruskall-Wallis tests.

Related Experiment Videos

  • Examination of variables including maternal demographics, trauma type, gestational age, and fetal monitoring.

    • Main Results:

    • Motor vehicle accidents (54.6%), domestic abuse (22.3%), and falls (21.8%) were common trauma types.
    • Early warning symptoms and abnormal Kleihauer-Betke tests did not reliably predict adverse outcomes.
    • Normal monitoring with absent warning signs demonstrated a 100% negative predictive value for adverse outcomes.

    Conclusions:

    • Initial 4-hour fetal monitoring is recommended; prolonged monitoring may not be beneficial.
    • Kleihauer-Betke testing is not recommended for Rh-positive women; Rh-immunoglobulin work-up is advised for Rh-negative patients.
    • Trauma prevention strategies integrated into prenatal care could significantly benefit pregnant individuals.