D R . A L L E N C H E R E R

PHYSICAL TRAUMA &PREGNANCY

Trauma is an important cause of maternal andfetal morbidity and mortality, and blunt abdominaltrauma is a particular concern. Approximately 8%

of pregnant women sustain some form oftraumatic injury. Automobile accidents and falls

account for most of the injuries.

Studies of pregnant womeninvolved in automobileaccidents havedemonstrated increasedrates of premature ruptureof membranes, placentalabruption, preterm birth,and stillbirth. A recentstudy examinespregnancies complicatedby traumatic injuries andoutcomes in relation toplace of triage.

According to theretrospective study publishedin the Journal of theAmerican College ofSurgeons, pregnant womenwho sustained traumaticinjuries and were triaged totrauma centers experiencedimproved pregnancyoutcomes compared towomen cared for in non-trauma hospitals.

For the study, the researchers linked two databases, theWashington State Birth Events Records Database and

the Comprehensive Hospital Abstract Recording System.

The method allowed them to assess the maternal andneonatal outcomes of all injured, pregnant women (3429

patients) who were hospitalized in Washington Statebetween the years 1995 and 2012.

The findings showed that after adjusting for a numberof confounding factors, including injury severity score,

pregnant women who were cared for in traumafacilities had better outcomes with significantly

decreased odds of preterm labor, preterm birth, andlow birth weight infants.

Since trauma centers are specialized medical facilities whichhave optimal processes and resources in place to monitor and

treat injured patients, the study suggests that many injured,pregnant women may in fact be under-triaged and treated in non-

trauma hospitals where their care may not be optimal.

According to the coauthors, John Distelhorst, DO, MPH andVijay Krishnamoorthy, MD, the findings may lead to furtheranalyses of state trauma systems and the triage of specificpatient populations to improve quality of care and patient

outcomes.

To read more about latest studies in Neonatal Care, pleasevisit Dr. Allen Cherer's website