Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, RI.
Am J Obstet Gynecol. 2013 Jul;209(1):1-10. doi: 10.1016/j.ajog.2013.01.021. Epub 2013 Jan 17.
We reviewed recent data on the prevalence, risk factors, complications, and management of trauma during pregnancy. Using the terms "trauma" and "pregnancy" along with specified mechanisms of injury, we queried the PubMed database for studies reported from Jan. 1, 1990, through May 1, 2012. Studies with the largest number of patients for a given injury type and that were population-based and/or prospective were included. Case reports and case series were used only when more robust studies were lacking. A total of 1164 abstracts were reviewed and 225 met criteria for inclusion. Domestic violence/intimate partner violence and motor vehicle crashes are the predominant causes of reported trauma during pregnancy. Management of trauma during pregnancy is dictated by its severity and should be initially geared toward maternal stabilization. Minor trauma can often be safely evaluated with simple diagnostic modalities. Pregnancy should not lead to underdiagnosis or undertreatment of trauma due to unfounded fears of fetal effects. More studies are required to elucidate the safest and most cost-effective strategies for the management of trauma in pregnancy.
我们回顾了近期关于妊娠期创伤的发生率、危险因素、并发症和处理的相关数据。我们使用了“创伤”和“妊娠”这两个术语，并结合了特定的损伤机制，在 PubMed 数据库中查询了 1990 年 1 月 1 日至 2012 年 5 月 1 日期间发表的研究报告。我们纳入了在特定损伤类型中纳入患者数量最多的、基于人群的前瞻性研究。只有在缺乏更有力的研究时，才会使用病例报告和病例系列。共审查了 1164 篇摘要，其中 225 篇符合纳入标准。在报告的妊娠期创伤中，家庭暴力/亲密伴侣暴力和机动车事故是主要原因。妊娠期创伤的处理取决于其严重程度，最初应侧重于母体的稳定。轻度创伤通常可以通过简单的诊断方法安全评估。由于对胎儿影响的毫无根据的担忧，不应导致对创伤的诊断不足或治疗不足。需要进一步研究以阐明妊娠期创伤管理的最安全和最具成本效益的策略。
