Trauma in pregnant women: analysis of maternal and fetal mortality

Injury. 1999 May;30(4):239-43. doi: 10.1016/s0020-1383(98)00250-2.

Abstract

Twenty-seven traumatised pregnant women were analysed retrospectively over a period of 9 years. Mean age was 23.7 years (16-42 years). Gestational age ranged from 10 to 40 weeks (mean, 21.5 weeks), with most victims (46.1%) being in the second trimester. The predominant mechanism (65.3%) was blunt abdominal injury due to an automobile accident (the patient being run over or collision). At admission, 8 (30.7%) patients had haemodynamic alterations. 6 patients (23.0%) presented vaginal bleeding and 4 of these were haemodynamically normal. We analysed maternal mortality, fetal mortality and their causes. We also compared the median RTS and TRISS values for the groups with maternal-fetal survival and the group with maternal-fetal death. Fetal death occurred in all pregnant women admitted with vaginal bleeding. Maternal mortality due to haemorrhagic shock was 11.5%. Fetal mortality was 30.7%, with 37.5% of these deaths being caused by maternal death. The major cause of fetal mortality was a detached placenta (50.0%). The trauma indices, RTS and TRISS, were significantly lower (p = 0.0025 and p < 0.0001) in the group of maternal-fetal death but they were not of prognostic value in terms of fetal mortality.

MeSH terms

  • Adolescent
  • Adult
  • Brazil / epidemiology
  • Cause of Death
  • Female
  • Fetal Death / epidemiology*
  • Humans
  • Maternal Mortality
  • Pregnancy
  • Pregnancy Complications / mortality*
  • Prognosis
  • Retrospective Studies
  • Trauma Severity Indices
  • Wounds and Injuries / mortality*