Garmi Gali, Marjieh Mary, Salim Raed
Department of Obstetrics and Gynecology, Emek Medical Center, 18101, Afula, Israel.
Arch Gynecol Obstet. 2014 Oct;290(4):635-41. doi: 10.1007/s00404-014-3256-y. Epub 2014 May 6.
To investigate pregnancy outcome after minor trauma and to identify risk factors at admission that may predict adverse pregnancy outcome.
A retrospective study held between January-2005 and December-2011. Pregnant women at 23 weeks or more, who were admitted due to minor trauma, were included. A standard protocol was applied: physical examination, lab tests and a fetal heart rate monitoring (FHRM) and tocometer for 1 h. In cases of symptomatic women, abnormal FHRM or presence of uterine contractions, the length of monitoring was extended. All women were admitted for 24 h of observation. The primary outcome was a composite adverse outcome that included at least one of the following: placental abruption, preterm birth and birthweight <2,500 g. To investigate pregnancy outcome and identify risk factors that may predict pregnancy outcome, matched (1:2) non-trauma controls were included. Risk factors examined included maternal obstetric variables, complaints at admission, clinical findings, lab test results, FHRM and tocometer findings.
A total of 512 women with minor trauma and 1,024 non-trauma controls were included. Composite outcome occurred in 48 (9.4 %) and 131 (12.9 %) of the study and the control groups, respectively (p = 0.04; OR 0.71; 95 % CI, 0.5-0.99). None of the parameters examined at admission predicted the occurrence of the composite outcome.
Pregnant women after minor trauma have a favorable pregnancy outcome. None of the parameters examined at admission were predictive of adverse outcome. Extensive evaluation at admission and observation for 24 h are probably unnecessary following minor trauma, particularly for asymptomatic women.
研究轻度创伤后的妊娠结局,并确定入院时可能预测不良妊娠结局的危险因素。
进行一项回顾性研究,时间跨度为2005年1月至2011年12月。纳入孕周23周及以上因轻度创伤入院的孕妇。采用标准方案:体格检查、实验室检查、1小时的胎儿心率监测(FHRM)和宫缩图监测。对于有症状的女性、FHRM异常或有子宫收缩的情况,监测时间延长。所有女性均入院观察24小时。主要结局是复合不良结局,包括以下至少一项:胎盘早剥、早产和出生体重<2500g。为了研究妊娠结局并确定可能预测妊娠结局的危险因素,纳入了匹配的(1:2)非创伤对照组。检查的危险因素包括产妇产科变量、入院时的主诉、临床检查结果、实验室检查结果、FHRM和宫缩图检查结果。
共纳入512例轻度创伤女性和1024例非创伤对照组。研究组和对照组的复合结局分别发生在48例(9.4%)和131例(12.9%)中(p = 0.04;OR 0.71;95% CI,0.5 - 0.99)。入院时检查的参数均未预测复合结局的发生。
轻度创伤后的孕妇妊娠结局良好。入院时检查的参数均不能预测不良结局。轻度创伤后,尤其是无症状女性,入院时进行广泛评估和24小时观察可能没有必要。