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Abstract
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BACKGROUND: Motor vehicle crashes (MVC) are a leading cause of death in pregnant women. Even after minor trauma there is risk of fetal complications. The purpose of this study was to compare injuries and outcomes in pregnant with matched non-pregnant females after MVC, and evaluate the incidence and type of pregnancy-related complications.
METHODS: Retrospective study at a Level I trauma center included pregnant MVC patients, admitted 2009-2019. Pregnant patients were matched for age, seat-belt use, and airbag deployment with non-pregnant females (1:3). Gestation-related complications included uterine contractions, vaginal bleeding, emergency delivery, and fetal loss.
RESULTS: During the study period, there were 6,930 MVC female admissions. 145 (2%) were pregnant, matched with 387 non-pregnant. The seat belt use (71% in non-pregnant vs 73% in pregnant, p=0.495) and airbag deployment (10% vs 6%, p=0.098) were similar in both groups. Non-pregnant females had higher ISS (4 vs. 1, p <0.0001) and abdominal AIS (2 vs 1, p <0.001), but a smaller proportion sustained abdominal injury (18% vs. 53%, p<0.0001). Mortality (1% vs. 0.7%, p=0.722), need for emergency operation (6% vs. 3%, p=0.295) or angiointervention (0.3% vs. 0%, p=0.540), ventilator days (3 vs. 8, p=0.907), and ICU (4 vs. 4, p=0.502) and hospital length of stay (2 vs. 2, p=0.122) were all similar. Overall, 13 patients (11.1%) developed gestation-related complications, most commonly uterine contractions (6.3%), need for emergency delivery (3.5%), and vaginal bleeding (1.4%).
CONCLUSIONS: Most pregnant patients hospitalized for MVC suffered minor injuries. Pregnant women had lower ISS and abdominal AIS than matched non-pregnant women. However, there was still a considerable incidence of gestation-related complications. It is imperative that pregnant patients be closely monitored after even minor trauma. LEVEL OF EVIDENCE: Level IIISTUDY TYPEPrognostic and epidemiological.
Language: en |