孕妇创伤患者胎儿分娩的预测因素:一个多中心研究
Jeffrey W Santos1, Areg Grigorian, Alexa N Lucas
1From the Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, (J.W.S., A.G., A.N.L., E.T.-L., D.C.Z., J.N.), University of California, Irvine, Orange; Department of Surgery (N.F., N.K.D., E.J.L.), Cedars-Sinai Medical Center, Los Angeles; Division of Trauma and Critical Care (J.S.), Harbor-UCLA Hospital, Torrance; Department of Trauma, Acute Care Surgery, Surgical Critical Care (S.B.), Loma Linda Medical Center, Loma Linda; Riverside School of Medicine (A.D.), University of California, Riverside; Cottage Health Research Institute (A.J., W.G.), Santa Barbara Cottage Hospital, Santa Barbara; Trauma and Acute Care Surgery, Scripps Memorial Hospital (W.L.B., D.B., M.C.), La Jolla; Department of Surgery (D.W., K.B.S.), Sharp Memorial Hospital, San Diego; Department of Surgery (D.J.Z., A.T.), UCLA David Geffen School of Medicine, Los Angeles; Department of Surgery, Comparative Effectiveness and Clinical Outcomes Research Center-CECORC (R.C., R.T.), Riverside University Health System Medical Center, Moreno Valley; Division of Trauma, Surgical Critical Care, Burns and Acute Care Surgery (J.E.S.), University of California San Diego School of Medicine, San Diego; Division of Acute Care Surgery (B.E., M.S., K.I.), LAC+USC Medical Center, University of Southern California, Los Angeles; and Department of Trauma (T.K.D., G.D.), Ventura County Medical Center, Ventura, California.
大约10%的孕妇创伤患者过早分娩. 创伤后分娩的关键预测因素包括腹部损伤,妊娠年龄,异常的胎儿心脏跟踪和膜的过早破裂.
科学领域:
- 创伤外科 手术 创伤外科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 产科 产科 产科 产科 产科
背景情况:
- 孕妇创伤患者 (PTP) 需要在受伤后进行观察和胎儿监测.
- 关于PTP结果和创伤后胎儿分娩 (FD) 的风险因素的数据有限.
- 识别FD的预测因素对于管理PTP至关重要.
研究的目的:
- 在潜在的可行的怀孕中确定创伤后胎儿分娩 (FD) 的独立预测因素.
主要方法:
- 一项多中心的回顾性研究包括从2016年到2021年的PTP (≥18岁,≥24周妊娠年龄).
- 在住院期间进行FD (+) FD) 的PTP与没有进行 (-) FD) 的PTP进行了比较.
- 利用单变量分析和多变量逻辑回归来确定FD预测因素.
主要成果:
- 在591名PTP中,10.7%接受了FD. (+) FD组的妊娠年龄,损伤严重程度和阴道出血,子宫收缩和胎儿心脏追踪异常的发生率较高.
- FD的独立预测因素包括腹部损伤 (OR,4.07),妊娠年龄 (OR,每周1.68),异常的胎儿心脏跟踪 (OR,12.72),以及膜的过早破裂 (OR,35.97).
结论:
- 对于具有可行的妊娠年龄的PTP,胎儿分娩率为~10%.
- 孕产妇和胎儿的因素,通常在初步评估时可用,预测创伤患者的FD.
- 这些发现可以为创伤环境中PTP观察的指导方针提供信息.


