Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, New York 10032, USA.
Am J Perinatol. 2010 Aug;27(7):579-86. doi: 10.1055/s-0030-1249358. Epub 2010 Mar 2.
Trauma in pregnancy remains one of the major contributors to maternal and fetal morbidity and mortality. Potential complications include maternal injury or death, shock, internal hemorrhage, intrauterine fetal demise, direct fetal injury, abruptio placentae, and uterine rupture. The leading causes of obstetric trauma are motor vehicle accidents, falls, assaults, and gunshots, and ensuing injuries are classified as blunt abdominal trauma, pelvic fractures, or penetrating trauma. Many of the assessment and management aspects of obstetric trauma are unique to pregnancy, although initial evaluation and resuscitation should always be maternally directed. Once maternal stability is established, vigilant evaluation of fetal well-being becomes warranted. Continuous fetal heart monitoring, ultrasonography, computed tomography, open peritoneal lavage, and/or exploratory laparotomy may be indicated in a case of obstetric trauma. In view of the significant impact of trauma on the pregnant woman and her fetus, preventive strategies are paramount.
妊娠相关创伤仍然是导致孕产妇和胎儿发病率和死亡率的主要原因之一。潜在的并发症包括母体损伤或死亡、休克、内出血、宫内胎儿死亡、直接胎儿损伤、胎盘早剥和子宫破裂。产科创伤的主要原因是机动车事故、跌倒、袭击和枪击，由此导致的损伤分为钝性腹部创伤、骨盆骨折或穿透性创伤。尽管初始评估和复苏始终应针对母体，但产科创伤的许多评估和管理方面都是妊娠所特有的。一旦母体稳定，就需要对胎儿的健康状况进行警惕性评估。在产科创伤的情况下，可能需要连续胎儿心脏监测、超声检查、计算机断层扫描、剖腹腹腔灌洗和/或剖腹探查术。鉴于创伤对孕妇及其胎儿的重大影响，预防策略至关重要。
