بررسی فراوانی، نوع و پیامدهای تروما در دوران بارداری در مراجعین به مرکز ارجاعی ترومای گیلان از تیرماه سال 1396 تا تیر 1398

نوع مقاله : اصیل پژوهشی

نویسندگان

1 کارشناس ارشد مدیریت منابع انسانی، مرکز تحقیقات ترومای جاده‌ای، دانشگاه علوم پزشکی گیلان، رشت، ایران.

2 استادیار پژوهشی، دکتری اقتصاد سلامت، مرکز تحقیقات ترومای جاده‌ای، دانشگاه علوم پزشکی گیلان، رشت، ایران.

3 دانشجوی پزشکی عمومی، مرکز تحقیقات ترومای جاده‌ای، دانشکده پزشکی، دانشگاه علوم پزشکی گیلان، رشت، ایران.

4 کارشناس پرستاری، مرکز آموزشی درمانی پورسینا، دانشگاه علوم پزشکی گیلان، رشت، ایران.

5 استادیار پژوهشی، دکتری آموزش پرستاری، مرکز تحقیقات ترومای جاده‌ای، دانشگاه علوم پزشکی گیلان، رشت، ایران.

چکیده

مقدمه: تروما اولین علت مرگ‌و‌میر زنان باردار به‌دلایل غیر از بارداری است. دانش محدودی درباره مکانیسم­های ترومای بارداری وجود دارد، لذا مطالعه حاضر با هدف تعیین فراوانی، نوع و پیامدهای تروما در دوران بارداری در مراجعین مرکز بزرگ ترومای گیلان انجام شد.
روش‌کار: این مطالعه توصیفی- مقطعی و گذشته‌نگر، با استفاده از داده­های ثبت شده در تریاژ مرکز آموزشی- درمانی پورسینا واقع در استان گیلان از زمان شروع به کار این سیستم ثبت یعنی از تاریخ تیر ماه 1396 انجام شد و به‌صورت تمام شماری، تمام مادران تروما دیده تا تیر ماه 1398 که 138 نفر بودند، وارد مطالعه شده و سپس با استفاده از مصاحبه تلفنی، پیامدهای بعد از ترخیص مادر و جنین پرسش شد که در مجموع 77 مادر پاسخگو بودند. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 21) انجام شد.
یافته‌ها: میانگین سن مصدومین 25/5±24/29 سال و میانگین سن بارداری آنها 12/10±92/20 هفته بود. شایع‌ترین مکانیسم تروما سقوط (5/35%) و پس از آن به‌ترتیب حوادث ترافیکی (9/31%)، سایر مکانیسم‌ها (فرورفتن جسم نوک تیز در اندام‌ها، افتادن جسم خارجی بر روی فرد، سگ گاز گرفتگی و ...) (21%)، خشونت و نزاع (9/10%) و خودزنی (7/0%) بود. بیشترین پیامدهای جنینی گزارش شده به‌ترتیب فراوانی، بدون پیامد (87%)، تولد زودرس (8/7%) و سقط (2/5%) بود و بیشترین پیامدهای مادری به‌ترتیب فراوانی، بدون عارضه (5/67%)، خونریزی (7/11%)، شکستگی استخوان (7/11%)، انقباضات رحمی و باز شدن دهانه رحم (1/9%) گزارش شده بود.
نتیجه­گیری: شایع‌ترین نوع تروما در دوران بارداری سقوط بود. تولد زودرس و سقط از پیامد­های جنینی و خونریزی، شکستگی استخوان، انقباضات رحمی و باز شدن دهانه رحم از پیامدهای مادری خطرناکی بودند که گزارش شدند. در برنامه­های بعدی باید پیشگیری از این تروماها در بارداری و پیگیری پیامدهای بعد از ترخیص مادران از مراکز تروما در الویت باشد.

کلیدواژه‌ها

عنوان مقاله [English]

The frequency, type and outcomes of trauma during pregnancy in patients referring to the trauma referral center in Guilan from July 2017 to July 2019

نویسندگان [English]

  • Leila Kouchakinejad Eramsadati 1
  • Enayatollah Homaie Rad 2
  • Nasrieh Khalatbari Soltani 3
  • Masoumeh Foroutan 4
  • Naema Khodadadi Hassankiadeh 5
1 M.Sc. in Human Resources Management, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
2 Assistant professor, Department of Research, PhD in Health Economics, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
3 Medical student, Guilan Road Trauma Research Center, Faculty of Medicine, Guilan University of Medical Sciences, Rasht, Iran.
4 B.Sc. in Nursing, Poursina Teaching Center, Guilan University of Medical Sciences, Rasht, Iran.
5 Assistant professor, Department of Research, Guilan Road Trauma Research Center, Guilan University of Medical Sciences, Rasht, Iran.
چکیده [English]

Introduction: Trauma is the first cause of mortality due to non-obstetric causes in pregnant women. There is a limited knowledge on mechanisms of trauma in pregnancy. Therefore, this study was performed with aim to determine the frequency, type and outcomes of trauma in pregnancy period in patients referring to the major trauma center in Guilan.
Methods: This retrospective cross-sectional study was conducted using the data registered in triage unit of Poursina Teaching center, Guilan from July 2017 when the Hospital Information System was being implemented for the first time. Using complete enumeration, all mothers with trauma histories until July 2018 (n=138) were entered into the study. They were then interviewed via telephone about the maternal and fetal outcomes after discharge, and 77 mothers answered. Data were analyzed using SPSS software (Version 21).
Results:The mean of maternal age was 29.24±5.25 years and mean gestational age was 20.92±10.12 weeks. The most common mechanism of trauma was falling (35.5%) and then traffic accidents (31.9%), other mechanisms (sharp objects penetrating in the limbs, falling of the object on the person, dog bite, etc.) (21%), violence (10.9%) and self-immolation (0.7%). In terms of frequency, the most reported fetal outcomes were without outcome (87%), preterm birth (7.8%) and abortion (5.2%), respectively; the most common maternal outcomes were reported as uncomplicated (67.5%), bleeding (11.7%), bone fractures (11.7%), uterine contractions and cervical dilatation (9.1%).
Conclusion: The most common type of trauma during pregnancy was falling. Preterm birth and abortion were the fetal outcomes and vaginal bleeding, bone fracture, uterine contraction, and cervical opening were dangerous maternal outcomes which are reported. Future programs should prioritize trauma prevention in pregnancy and follow-up of maternal outcomes after discharge from trauma center.

کلیدواژه‌ها [English]

  • Fetal outcome
  • Maternal outcome
  • Pregnancy
  • Trauma

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مجله زنان، مامایی و نازایی ایران
دوره 24، شماره 6
شهریور 1400
صفحه 80-89

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