Department of Obstetrics and Gynecology, Mott Hospital, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, MI 48109, USA.
Semin Perinatol. 2012 Feb;36(1):60-7. doi: 10.1053/j.semperi.2011.09.012.
Maternal mortality is an important indicator of adequacy of health care in our society. Improvements in the obstetric care system as well as advances in technology have contributed to reduction in maternal mortality rates. Trauma complicates up to 7% of all pregnancies and has emerged as the leading cause of maternal mortality, becoming a significant concern for the public health system. Maternal mortality secondary to trauma can often be prevented by coordinated medical care, but it is essential that caregivers recognize the unique situation of providing simultaneous care to 2 patients who have a complex physiologic relationship. Optimal management of the pregnant trauma victim requires a multidisciplinary team, where the obstetrician plays a central role. This review focuses on the incidence of maternal mortality due to trauma, the mechanisms involved in traumatic injury, the important anatomic and physiologic changes that may predispose to mortality due to trauma, and finally, preventive strategies that may decrease the incidence of traumatic maternal death.
产妇死亡率是评估我们社会医疗保健水平的重要指标。产科医疗体系的改善和技术的进步，有助于降低产妇死亡率。创伤可使高达 7%的妊娠复杂化，且已成为产妇死亡的主要原因，这对公共卫生系统来说是一个重大的问题。通过协调医疗护理，往往可以预防因创伤导致的产妇死亡率，但护理人员必须认识到为 2 名具有复杂生理关系的患者同时提供护理的独特情况。对创伤孕妇的最佳管理需要多学科团队，其中产科医生发挥着核心作用。本文重点讨论了因创伤导致的产妇死亡率的发生率、创伤相关损伤的机制、可能导致创伤性死亡的重要解剖和生理变化，以及最后可能降低创伤性产妇死亡发生率的预防策略。
