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- Title
Fetal Death after Trauma in Pregnancy.
- Authors
Theodorou, Dimitrios A.; Velmahos, George C.; Souter, Irene; Chan, Linda S.; Vassiliu, Pantelis; Tatevossian, Raymond; Murray, James A.; Demetriades, Demetrios
- Abstract
Trauma in pregnancy places the mother and fetus at risk. The objective of this study is to identify risk factors independently associated with acute termination of pregnancy and/or fetal mortality after trauma. The medical and trauma registry records of 80 injured pregnant patients were reviewed. Data were collected and then analyzed by univariate and multivariate analysis. Three patients died (3.7%), 23 had the pregnancy acutely terminated (30%), and 14 suffered fetal death (17.5%). The only independent risk factors for fetal mortality were an Injury Severity Score (ISS) is greater than or equal to 9 and a nonviable pregnancy (<23 weeks). The combination of both risk factors increased the likelihood of fetal mortality by fivefold over that of patients without either risk factor. Maternal hemodynamic parameters did not predict fetal loss. Two patients lost their fetuses despite insignificant trauma (ISS = 1) and normal hemodynamic parameters, whereas eight delivered normal babies despite major trauma (ISS is greater than or equal to 16). Hemodynamic stability on admission does not predict fetal mortality. Although the presence of moderate to severe injuries (ISS is greater than or equal to 9) increases the likelihood of fetal mortality, this complication may occur even with insignificant trauma. Close maternal and fetal monitoring is justified, regardless of maternal hemodynamic presentation or severity of injury.
- Subjects
PREGNANCY complications; ABORTION; CAUSES of fetal death
- Publication
American Surgeon, 2000, Vol 66, Issue 9, p809
- ISSN
0003-1348
- Publication type
Article
- DOI
10.1177/000313480006600901