Trauma in Pregnancy

Kissinger, David P.; Rozycki, Grace S.; Morris, John A.; Knudson, M. Margaret; Copes, Wayne S.; Bass, Sue M.; Yates, HL; Champion, Howard R.

doi:10.1001/archsurg.1991.01410330033004

Cited by 135 publications

(23 citation statements)

References 33 publications

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“…The safety of the mother is one side of the story. The adverse effects of maternal head trauma and altered mental status for fetal viability have been shown previously (18, 27). Thus, the practice in this item should be cautious due to our knowledge gap.…”

Section: Discussionmentioning

confidence: 53%

Adaptation of Traumatic Brain Injury Guidelines in Iran

et al. 2016

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ContextThe National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country.Evidence AcquisitionThe guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed.ResultsThe following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge.ConclusionsThe evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.

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Section: Discussionmentioning

confidence: 53%

Adaptation of Traumatic Brain Injury Guidelines in Iran

et al. 2016

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“…The fetal loss rate of 7.9% observed was toward the range of 4-61% reported in other studies. [3810151819]…”

Section: Discussionmentioning

confidence: 99%

“…An ISS cut-off point of 9 was used because prior studies have reported its high sensitivity and specificity in predicting fetal death. [910]…”

Section: Methodsmentioning

confidence: 99%

Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome

Njoku

Joannes

Madubueze

et al. 2013

Int J Crit Illn Inj Sci

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Context:Trauma is an important health concern during pregnancy in developing nations though it is under-reported.Aims:The aim of this study was to determine the patterns of presentation and feto- maternal outcomes of trauma during pregnancy in a Nigerian setting.Settings and Design:A hospital-based retrospective analysis of database of entire patient population who presented in Ebonyi State University Teaching Hospital, Abakaliki, with trauma during pregnancy.Materials and Methods:The data on demographics, obstetrics, and injury characteristic in addition to the outcome of all injured pregnant women hospitalized from January 2002 to December 2010 were analyzed.Statistical Analysis:SPSS version 16 and quantitative skills software SISA were used in data analysis.Results:Trauma-necessitated hospitalization in 12 per 1000 pregnant women admitted in antenatal ward and was a complication of pregnancy in 4.7 per 1000 live birth in the hospital. Physical assault was the predominant causative factor and accounted for 46% of injuries whereas road traffic accident (motorcycle injury related in over 80%) was involved in 30.2% of the patients. The parity of the patients was significantly related to the trimester of pregnancy at the time of injury - 73% of grand-multiparae and about 60% of primigravida involved presented with injury in the 3rd and 2nd trimester, respectively (P < 0.017). Preterm delivery (7.9%), abruptio placentae (4.8%), and stillbirth (4.8%) were common obstetric complications observed. Maternal mortality of 1.6% and fetal loss of 7.9% were associated with trauma.Conclusions:Injury prevention measures during pregnancy deserve a place in any policy response aimed at reducing feto-maternal morbidity and mortality in developing countries.

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“…1,2,3,4 Of the causes of trauma, motor vehicle accidents followed by domestic violence and falls are mostly responsible for abdominal injuries in pregnant women in compared to their nonpregnant counterparts. The immediate and long-term management of traumatic injury in pregnant women varies depending on the location and magnitude of the injury.…”

Section: Discussionmentioning

confidence: 99%

“…Fetal heart rate should also be regularly monitored to specify how advanced pregnancy is and if the fetus would be viable if delivered. 1,2,3,4 …”

Section: Discussionmentioning

confidence: 99%

Traumatic injuries in pregnant women: A case of motor vehicle accident for "Ground Round" discussion

Ahmadi¹,

Fakheri²,

Aminisaman³

et al. 2011

J Inj Violence Res

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Abstract:The main objective for introducing this case study is to create a platform from which the importance of road traffic related injuries and traumas can be emphasized and discussed within and across various fields of investigation. The long term goal is to entice public campaign around unmet needs for higher road safety measures to reduce primary, secondary, and tertiary risks of injuries and traumas. Case:A 28-year-old pregnant woman with a 16-week gestational age fetus was involved in a road car crash resulting in multiple traumas. Evaluation and treatment was initiated in the local Urgent Care Unit and continued in the emergency department and operation room. Patient underwent the following procedures: laparotomy, diverting colostomy, terminating pregnancy, right calcaneal traction and long leg splint, as well as multiple irrigation-debridements. Finally, the wound was left open and the patient was admitted to Intensive Care Unit. We hope that the introduction of this case for a "Ground Round" discussion will stir up a comprehensive discussion regarding the injury and trauma related preventive measures as well as treatment approaches in cases involving pregnant women in car accidents, and will bring about a holistic overview of this issue by the experts in various fields.

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Trauma in Pregnancy

Cited by 135 publications

References 33 publications

Adaptation of Traumatic Brain Injury Guidelines in Iran

Adaptation of Traumatic Brain Injury Guidelines in Iran

Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome

Traumatic injuries in pregnant women: A case of motor vehicle accident for "Ground Round" discussion

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