Trauma in Pregnancy: A Case Series and Literature Review

Document Type : Case report

Authors

1 Assistant Professor, Department of Emergency Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

2 Resident of Emergency Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction: Trauma in pregnancy is a major cause of hospital admission and maternal and fetal mortality. Some of the main complications of trauma in pregnant women are intrauterine death, shock, placental abruption, intraperitoneal hemorrhage, and direct fetal injury. The present study aimed to report some of the cases of trauma in pregnancy and review the previous studies in this regard.
Case Presentation: In this case series, we presented the case of four pregnant women with trauma, who referred to various teaching hospitals in Mashhad, Iran. The subjects had blunt abdominal trauma, burn injuries, multiple trauma, and traumatic brain injury.
Conclusion: Stabilizing the mother is the primary goal in the management of traumatized, pregnant patients. In many cases, fetal outcome is directly correlated with the rapid, thorough maternal resuscitation. In viable fetuses, fetal monitoring is crucial. On the other hand, due to the high rate of complications during pregnancy, educational interventions should be considered for pregnant women and their families. Furthermore, pregnant women must be aware of risky conditions, such as motorcycle riding and not using seatbelts.

Keywords

References

  1. Murphy NJ, Quinlan JD. Trauma in pregnancy: assessment, management, and prevention. Am Fam Physician 2014; 90(10):717-22.
  2. Mendez-Figueroa H, Dahlke JD, Vrees RA, Rouse DJ. Trauma in pregnancy: an updated systematic review. Am J Obstet Gynecol 2013; 209(1):1-10.
  3. Mirza FG, Devine PC, Gaddipati S. Trauma in pregnancy: a systematic approach. Am J Perinatol 2010; 27(7):579-86.
  4. Masoudi M, Asti P. High risk pregnancy due to physical traumas in pregnant women referred to forensic medicine center and university treatment centers of Khorramabad. Yafte 2009; 10(2):39-44. (Persian).
  5. Gissler M, Deneux-Tharaux C, Alexander S, Berg CJ, Bouvier-Colle MH, Harper M, et al. Pregnancy-related deaths in four regions of Europe and the United States in 1999-2000: characterisation of unreported deaths. Eur J Obstet Gynecol Reprod Biol 2007; 133(2):179-85.
  6. Karimi-Zarchi M, Ghane-Ezabadi M, Vafaienasab M, Dehghan A, Ghasemi F, Zaidabadi M, et al. Maternal mortality in Yazd Province, Iran. Electron Physician 2016; 8(2):1949-54.
  7. Vaghardoost R, Kazemzadeh J, Rabieepoor S. Epidemiology of burns during pregnancy in Tehran, Iran. Burns 2016; 42(3):663-7.
  8. Zangene M, Ebrahimi B, Najafi F. Trauma in pregnancy and its consequences in Kermanshah, Iran from 2007 to 2010. Glob J Health Sci 2014; 7(2):304-9.
  9. Schiff MA. Pregnancy outcomes following hospitalization for a fall in Washington State from 1987 to 2004. BJOG 2008; 115(13):1648-54.
  10. Vladutiu CJ, Evenson KR, Marshall SW. Physical activity and injuries during pregnancy. J Phys Act Health 2010; 7(6):761-9.
  11. Dunning K, LeMasters G, Levin L, Bhattacharya A, Alterman T, Lordo K. Falls in workers during pregnancy: risk factors, job hazards, and high risk occupations. Am J Ind Med 2003; 44(6):664-72.
  12. Pearlman MD, Viano D. Automobile crash simulation with the first pregnant crash test dummy. Am J Obstet Gynecol 1996; 175(4 Pt 1):977-81.
  13. Jaffe R, Fejgin M. Accidental electric shock in pregnancy: a prospective cohort study. Am J Obstet Gynecol 1997; 177(4):983-4.
  14. Huls CK, Detlefs C. Trauma in pregnancy. Semin Perinatol 2018; 42(1):13-20.
  15. Redelmeier DA, May SC, Thiruchelvam D, Barrett JF. Pregnancy and the risk of a traffic crash. CMAJ 2014; 186(15):1169.
  16. Wiencrot A, Nannini A, Manning SE, Kennelly J. Neonatal outcomes and mental illness, substance abuse, and intentional injury during pregnancy. Matern Child Health J 2012; 16(5):979-88.
  17. Awwad JT, Azar GB, Seoud MA, Mroueh AM, Karam KS. High-velocity penetrating wounds of the gravid uterus: review of 16 years of civil war. Obstet Gynecol 1994; 83(2):259-64.
  18. Arsh A, Darain H, Ilyas SM, Zeb A. Consequences of traumatic spinal cord injury during pregnancy in Pakistan. Spinal Cord Ser Cases 2017; 3:17041.
  19. Omerović S, Tomasch E, Gutsche AJ, Prebil I. Comparative study of potential whiplash injuries for different occupant seated positions during rear end accidents. Acta Bioeng Biomech 2016; 18(4):145-58.
  20. Redelmeier DA, Naqib F, Thiruchelvam D, R Barrett JF. Motor vehicle crashes during pregnancy and cerebral palsy during infancy: a longitudinal cohort analysis. BMJ Open 2016; 6(9):e011972.
The Iranian Journal of Obstetrics, Gynecology and Infertility
Volume 21, Issue 6
August 2018
Pages 92-99

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