Document Detail


Abdominal injuries in pregnancy: a 155-month study at two level 1 trauma centers.
MedLine Citation:
PMID:  20655042     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Trauma in pregnancy is the leading cause of non-obstetrical maternal death and remains a major cause of fetal demise. The objective of this study was to examine the outcomes of pregnant patients sustaining abdominal injury.
PATIENTS AND METHODS: This is a retrospective analysis of all pregnant trauma patients admitted to two level 1 trauma centers from February 1, 1996 to December 31, 2008. Patient data abstracted included mechanism of injury, physiologic parameters on admission, Injury Severity Score (ISS), abdominal Abbreviated Injury Scale (AIS), gestational age, diagnostic and surgical procedures performed,complications, and maternal and fetal mortality. Univariate analysis and logistic regression analysis were used.
RESULTS: During the 155-month study period, 321 pregnant patients were included, of which 291 (91%)sustained a blunt injury, while 30 (9%) were victims of penetrating trauma. Of the penetrating injuries,22 (73%) were gunshot wounds, 7 (23%) stab wounds, and 1 (4%) shotgun injury. The overall maternal and fetal mortality was 3% (n = 9) and 16% (n = 45), respectively. Mean age was 22 6 year-old, and the mean ISS was 12 16. The overall mean abdominal AIS was 2 1.2. When adjusted for age, abdominal AIS,ISS, and diastolic blood pressure, the penetrating trauma group experienced higher maternal mortality [7%vs. 2% (adjusted OR: 7; 95% CI: 0.65–79), p = 0.090], significantly higher fetal mortality [73% vs. 10% (adjusted OR: 34; 95% CI: 11–124), p < 0.0001] and maternal morbidity [66% vs. 10% (adjusted OR: 25; 95% CI: 9–79)p < 0.0001].
CONCLUSIONS: Fetal mortality and overall maternal morbidity remains exceedingly high, at 73% and 66%,respectively, following penetrating abdominal injury. Penetrating injury mechanism, severity of abdominal injury and maternal hypotension on admission were independently associated with an increased risk for fetal demise following traumatic insult during pregnancy.
Authors:
Patrizio Petrone; Peep Talving; Timothy Browder; Pedro G Teixeira; Orna Fisher; Alfredo Lozornio; Linda S Chan
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Injury     Volume:  42     ISSN:  1879-0267     ISO Abbreviation:  Injury     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-05-16     Completed Date:  2011-08-04     Revised Date:  2012-08-13    
Medline Journal Info:
Nlm Unique ID:  0226040     Medline TA:  Injury     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  47-9     Citation Subset:  IM    
Copyright Information:
2010 Elsevier Ltd. All rights reserved.
Affiliation:
Division of Acute Care Surgery (Trauma, Emergency Surgery & Surgical Critical Care), Department of Surgery, University of Southern California, Keck School of Medicine, LAC + USC Medical Center, Los Angeles, CA, United States. patrizio.petrone@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Abdominal Injuries / complications,  epidemiology*,  mortality
Adult
Female
Fetal Death
Fetal Mortality
Gestational Age
Humans
Injury Severity Score
Maternal Mortality
Pregnancy
Pregnancy Complications / epidemiology*,  mortality
Retrospective Studies
Statistics, Nonparametric
Trauma Centers / statistics & numerical data
Treatment Outcome
Wounds, Nonpenetrating / epidemiology*,  mortality
Wounds, Penetrating / epidemiology*,  mortality
Young Adult
Comments/Corrections
Comment In:
Injury. 2012 Jul;43(7):1223   [PMID:  21939969 ]

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