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  • Title: Trauma in pregnancy.
    Author: Baerga-Varela Y, Zietlow SP, Bannon MP, Harmsen WS, Ilstrup DM.
    Journal: Mayo Clin Proc; 2000 Dec; 75(12):1243-8. PubMed ID: 11126831.
    Abstract:
    OBJECTIVE: To determine whether the severity of maternal injury or other maternal and fetal variables will predict the outcome of pregnancy in the injured pregnant patient. PATIENTS AND METHODS: In this retrospective review of pregnant patients hospitalized at a level 1 trauma center from 1986 to 1996, we analyzed the maternal Injury Severity Score, maternal mortality, fetal-neonatal mortality, maternal hypotension, and fetal heart rate. RESULTS: Sixty-one pregnant women were identified who were hospitalized after trauma. The mean +/- SD maternal age was 26.6 +/- 6.6 years. The distribution of trauma per gestational age was 21%, 20%, and 59% for the first, second, and third trimester, respectively. The most common mechanism of injury was motor vehicle crashes. Long-term pregnancy outcome was available in 53 patients (87%). There was 1 maternal death. Fetal-neonatal death occurred in 8 (15%) of 53 pregnancies. Most maternal physiologic variables were not predictors of pregnancy outcome. We were unable to detect a difference in the distribution of Injury Severity Scores between viable and nonviable pregnancies. However, maternal hypotension and low fetal heart rate were common in nonviable pregnancies (P = .02). CONCLUSIONS: Maternal hypotension and fetal heart rate are potential predictors of pregnancy outcome after trauma. Other maternal and fetal physiologic variables are poor measures of fetal well-being and are unable to predict fetal outcome. Fetal-neonatal death does not necessarily correlate with severity of maternal injury.
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