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Fetal death after trauma in pregnancy.
Am Surg. 2000 Sep; 66(9):809-12.AS

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) > or =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 > or = 16). Hemodynamic stability on admission does not predict fetal mortality. Although the presence of moderate to severe injuries (ISS > or = 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.

Authors+Show Affiliations

Theodorou DA
Department of Surgery, Keck School of Medicine, University of Southern California, Los Angeles, USA.
Velmahos GC
No affiliation info available
Souter I
No affiliation info available
Chan LS
No affiliation info available
Vassiliu P
No affiliation info available
Tatevossian R
No affiliation info available
Murray JA
No affiliation info available
Demetriades D
No affiliation info available

MeSH

Abbreviated Injury ScaleAbortion, SpontaneousAdultAnalysis of VarianceCause of DeathConfidence IntervalsFemaleFetal DeathFetal MonitoringForecastingGlasgow Coma ScaleHemodynamicsHumansInjury Severity ScoreLikelihood FunctionsMonitoring, PhysiologicMultivariate AnalysisOdds RatioPregnancyPregnancy ComplicationsPregnancy OutcomeRegistriesRetrospective StudiesRisk FactorsSurvival RateWounds and Injuries

Pub Type(s)

Journal Article

Language

eng

PubMed ID

10993605

Citation

Theodorou, D A., et al. "Fetal Death After Trauma in Pregnancy." The American Surgeon, vol. 66, no. 9, 2000, pp. 809-12.
Theodorou DA, Velmahos GC, Souter I, et al. Fetal death after trauma in pregnancy. Am Surg. 2000;66(9):809-12.
Theodorou, D. A., Velmahos, G. C., Souter, I., Chan, L. S., Vassiliu, P., Tatevossian, R., Murray, J. A., & Demetriades, D. (2000). Fetal death after trauma in pregnancy. The American Surgeon, 66(9), 809-12.
Theodorou DA, et al. Fetal Death After Trauma in Pregnancy. Am Surg. 2000;66(9):809-12. PubMed PMID: 10993605.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fetal death after trauma in pregnancy. AU - Theodorou,D A, AU - Velmahos,G C, AU - Souter,I, AU - Chan,L S, AU - Vassiliu,P, AU - Tatevossian,R, AU - Murray,J A, AU - Demetriades,D, PY - 2000/9/19/pubmed PY - 2000/10/14/medline PY - 2000/9/19/entrez SP - 809 EP - 12 JF - The American surgeon JO - Am Surg VL - 66 IS - 9 N2 - 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) > or =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 > or = 16). Hemodynamic stability on admission does not predict fetal mortality. Although the presence of moderate to severe injuries (ISS > or = 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. SN - 0003-1348 UR - https://www.unboundmedicine.com/medline/citation/10993605/Fetal_death_after_trauma_in_pregnancy_ L2 - https://www.diseaseinfosearch.org/result/5922 DB - PRIME DP - Unbound Medicine ER -