Traumatic injuries to the pregnant patient: a critical literature review

Petrone, Patrizio; Jimenez-Morillas, P.; Axelrad, Alexander; Marini, Corrado P.

doi:10.1007/s00068-017-0839-x

Cited by 67 publications

(67 citation statements)

References 57 publications

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“…Excessive uterine activity with more than four contractions per hour may be indicative of PA. More than eight contractions per hour in the fi rst four hours is consistent with the diagnosis of PA [10,18,21]. Eighty percent occur within six hours of monitoring but may be delayed for up to 48 hours or even longer [1,2,5,6,13,15,20,21,27]. However, PA has not been reported when there is less than 1 contraction every 10 minutes over a four hour period [12,13,27].…”

Section: Placental Abruptionmentioning

confidence: 97%

“…Mild hypotension and tachycardia [1,2,4,[6][7][8][9][10]14,17,19,20] Vital signs poor marker of maternal and uteroplacental circulation [1,2,[6][7][8]13,14,17,[19][20][21][22] Peripheral vasodilation [4,8,10] Warm, dry and pink skin, even following signifi cant blood loss Hypervolemic state with increased cardiac output [1,2,[4][5][6][7][8][9][10]13,14,17,[19][20][21][22][23] Protective against haemorrhage and diffi cult detection of hypovolemia [1,[4][5][6]9,10,…”

Section: Cardiovascular Changesmentioning

confidence: 99%

“…Oesophageal sphincter relaxation and partial displacement into thorax Delayed gastric emptying and decreased bowel motility More gastric secretion with lower pH Compression of upper tract in supine position [2,4,5,6,8,10,13,14,17,19,21,22] Higher aspiration risk [2,4,5,6,8,9,10,13,14,15,17,18,19,22] Pregnancy complaints (nausea, vomiting and abdominal pain) can mimic symptoms following trauma [10] Superior displacement of intestines [2,4,5,8,10,13,17,19,22] Uterus shields abdominal structures [6,8,10] Upper abdomen penetrating injury likely to injure bowels [2,6,13,15,17,19] Lower abdominal penetrating injury likely to damage uterus and fetus [5,6,10] Ab...…”

Section: Cardiovascular Changesmentioning

confidence: 99%

“…The most common causes are Motor Vehicle Accidents (MVA), falls, assaults and burns with the order depending on the world region and the rate of intimate partner violence [1,2,[4][5][6][7][8][9][10]13]. Blunt trauma is more prevalent than penetrating trauma [5,7,9].…”

mentioning

confidence: 99%

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Management of the pregnant trauma patient: A literature study

Argent¹,

Verelst²,

Sabbé³

2020

Open J Trauma

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Background Trauma complicates approximately 7 % of pregnancies and is thereby the leading cause of non-obstetric morbidity and mortality during pregnancy [1-10]. The risk of traumatic injury increases with the advancement of pregnancy [4,8,10,11]. Pregnancy as such does not increase morbidity or mortality following trauma but leads to different mechanisms and patterns of injury with an increased vulnerability to abdominal injury [4,6,10,12]. One needs to bear in mind that trauma affects both mother and unborn child, with the latter having a higher mortality rate [4,13]. The spectrum of trauma severity is broad. Severe trauma often leads to fetal loss but minor trauma is responsible for the majority (60-70%) of fetal deaths due to its higher prevalence [2,4,10,12,14]. However, the likelihood of adverse fetal outcome is often unpredictable and does not correlate with the degree of trauma [4,15,16].

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Section: Placental Abruptionmentioning

confidence: 97%

Section: Cardiovascular Changesmentioning

confidence: 99%

Section: Cardiovascular Changesmentioning

confidence: 99%

mentioning

confidence: 99%

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Management of the pregnant trauma patient: A literature study

Argent¹,

Verelst²,

Sabbé³

2020

Open J Trauma

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“…In his review, Petrone [1] presents a critical literature overview showing the most common causes of trauma during pregnancy. Also factors such as morbidity, mortality and the impact upon perinatal outcomes associated with trauma are shown.…”

mentioning

confidence: 99%

Consequences and treatment aspects of trauma in female patients

Seebach¹,

Verboket

2019

Eur J Trauma Emerg Surg

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In Utero Exposure to Maternal Injury and the Associated Risk of Cerebral Palsy

et al. 2023

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ImportanceAlthough maternal unintentional injury during pregnancy has shown negative impacts on the mother and fetus, the evidence on its long-term associations with children’s neurodevelopment is limited.ObjectiveTo examine the association between maternal unintentional injury and cerebral palsy (CP) in offspring.Design, Setting, and ParticipantsThis was a population-based, longitudinal, cohort study of all in-hospital live births born between April 1, 2002, and March 31, 2017, in a publicly funded health care system setting of Ontario, Canada. Infants born more than 20 weeks’ gestation were included and followed up until March 31, 2018. Excluded from the analysis were stillbirths, infants with missing or invalid records, and births with missing or invalid birth characteristics. Data were analyzed from March 1 to June 30, 2021.ExposuresMaternal unintentional injury during pregnancy ascertained based on inpatient or emergency department diagnoses.Main Outcomes and MeasuresCP diagnosis between birth and the end of follow-up in 2018 with the CP case definition of a single inpatient or 2 or more outpatient diagnoses at least 2 weeks apart between birth and age 16 years.ResultsOf 2 110 177 children included in this study (mean [SD] gestational age, 38.8 [1.9] weeks; 1 082 520 male [51.3%]), 81 281 (3.9%) were exposed in utero to maternal unintentional injury. During a median (IQR) follow-up time of 8 (4-12) years, 5317 children (0.3%) were diagnosed with CP (292 CP cases [5.5%] were exposed to maternal unintentional injury). The mean incidence rates of CP were 4.36 and 2.93 per 10 000 child-years in the exposed and the unexposed group, respectively. Children exposed to maternal unintentional injury had a modest increase in the risk of CP, compared with those unexposed (hazard ratio [HR], 1.33; 95% CI, 1.18-1.50) after adjusting for maternal sociodemographic and clinical characteristics. Severe injuries that resulted in hospitalization and delivery within 1 week from the injury conferred higher risks of CP (adjusted HR, 2.18; 95% CI, 1.29-3.68 and adjusted HR, 3.40; 95% CI, 1.93-6.00, respectively). Results were robust in multiple bias analyses.Conclusions and RelevanceIn this Canadian population-based birth cohort study, in utero exposure to maternal unintentional injury was associated with an increased risk of CP, with a higher risk with more severe injuries. These findings fill an important gap in knowledge on the potential role of maternal injury on children’s neurodevelopment outcomes. Public health professionals and stakeholders should be aware of these potential long-term consequences on offspring when designing programs and providing recommendations about safety during pregnancy. Early monitoring and developmental assessment of children exposed to maternal injury might be warranted.

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Traumatic injuries to the pregnant patient: a critical literature review

Cited by 67 publications

References 57 publications

Management of the pregnant trauma patient: A literature study

Management of the pregnant trauma patient: A literature study

Consequences and treatment aspects of trauma in female patients

In Utero Exposure to Maternal Injury and the Associated Risk of Cerebral Palsy

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