Severe Head Trauma in a 39-Week Pregnant Woman with Amenorrhea (SA) Apropos of a Case at CHU Ignace Deen in Conakry

Abstract

Objective: Was to present the management of a pregnant woman at 39 SA received for severe head trauma in the emergency room. Severe trauma in pregnant women can have serious maternal and especially fetal consequences in the absence of a diagnostic and therapeutic strategy. We report the case of serious trauma in a 39 WA pregnant woman, nulliparous. Admitted to the emergency room for serious head trauma following a public road accident. The clinical picture was dominated by impaired consciousness with a Glasgow score of 8/15, right otorrhagia, desaturation at 89% AA and respiratory rate at 36 cycles/min. The obstetrical examination noted a fundal height of 32 cm, a fetal heart sound (BCF) of 167 beats/min, a cephalic presentation, a cervical opening of 3 cm and uterine contractures. Imaging examinations outside the hospital because not available. The abdominopelvic ultrasound shows a monofetal pregnancy without placental abruption. The cerebral scanner shows an edemato-haemorrhagic contusion intra parenchymatous frontotemporal left. Respiratory support and an indication for caesarean section allowed the extraction of a live male child, Apgar at one minute 10/10 to five minutes 10/10, weighing 3000 g without abnormality on clinical examination. The evolution was favorable after 27 days of resuscitation. Conclusion: The care of a severely traumatized pregnant woman relies above all on good multidisciplinary coordination, based on close collaboration between emergency physicians, anesthetists-resuscitators, obstetricians, pediatricians, neonatologists and biologists.