Williams J K, McClain L, Rosemurgy A S, Colorado N M
Department of Obstetrics and Gynecology, University of South Florida College of Medicine, Tampa.
Obstet Gynecol. 1990 Jan;75(1):33-7.
With the active life-style of today's pregnant women, the effects of trauma have become an important obstetric concern. A protocol was developed to monitor pregnancies complicated by major blunt abdominal trauma in the third trimester, looking specifically for delayed placental and/or fetal problems. Of the 84 pregnancies studied, the most serious complication was placental abruption. Although abruption occurred in only two cases, one case was associated with a ruptured uterus and fetal death. There were no cases of delayed abruption or delayed fetal compromise. The most common complication was preterm labor, occurring in 28% of cases when the traumatic insult happened before 37 weeks' gestation. Of these 17 patients, 15 were successfully treated with tocolysis. There were no cases of direct fetal injury or Rh-isoimmunization. A revised protocol is recommended for limited outpatient observation with nonstress testing and screening ultrasonography to rule out preterm labor and placental abruption and to document fetal well-being.
鉴于当今孕妇积极的生活方式，创伤的影响已成为产科关注的重要问题。制定了一项方案，用于监测妊娠晚期并发严重钝性腹部创伤的情况，特别关注胎盘和/或胎儿的延迟问题。在研究的84例妊娠中，最严重的并发症是胎盘早剥。虽然仅2例发生胎盘早剥，但其中1例伴有子宫破裂和胎儿死亡。没有延迟性胎盘早剥或延迟性胎儿窘迫的病例。最常见并发症是早产，当创伤发生在妊娠37周前时，28%的病例出现早产。在这17例患者中，15例通过宫缩抑制剂治疗成功治愈。没有直接胎儿损伤或Rh血型免疫的病例。建议修订方案以便进行有限的门诊观察，包括无应激试验和超声筛查，以排除早产和胎盘早剥并记录胎儿健康状况。
