Girard M, Marchand F, Uch R, Bretelle F
Pôle femme-enfant, Department of gynecology and obstetrics, hôpital Nord, Aix-Marseille université (AMU), Assistance publique-Hôpitaux de Marseille, 13015 Marseille, France.
Pôle femme-enfant, Department of gynecology and obstetrics, hôpital Nord, Aix-Marseille université (AMU), Assistance publique-Hôpitaux de Marseille, 13015 Marseille, France.
Gynecol Obstet Fertil Senol. 2017 Nov;45(11):584-589. doi: 10.1016/j.gofs.2017.08.009. Epub 2017 Sep 28.
To evaluate the pertinence of Kleihauer-Betke (KB) test, in case of abdominal trauma during pregnancy in forecast of fetal outcomes, according to trauma severity.
A single-center retrospective study conducted between January 2014 and April 2016 in a maternity type III and a trauma center, which included the pregnant women admitted for abdominal trauma. The trauma's severity was assessed using the guidelines of the Society of Obstetricians and Gynaecologists of Canada. The impact of a positive KB test, defined as>0.1%, was analyzed. Adverse outcome was defined as one or more of the following complications: intrauterine fetal death, placental abruption, pre-term birth<37 weeks of gestation, and fetal or neonatal anemia.
During the study period, 265 pregnancies involved into an abdominal trauma were included: 69% with a minor trauma and 31% with a severe trauma. Of all patients, 5.6% presented a positive KB test, among then 15.4% had an adverse outcome. There was no significant difference in the rate of adverse outcomes in the positive KB group and the KB negative group either in the overall population (P=0.16), in the minor trauma population (P=1) or in the major trauma population (P=0.14). The predictive positive values were respectively in the global population, in the minor trauma group and in the severe trauma group 15.4%, 0% and 25%.
The KB test does not seem to be useful in case of trauma during pregnancy to define adverse outcome.
根据创伤严重程度，评估孕期腹部创伤时Kleihauer-Betke（KB）试验对预测胎儿结局的相关性。
2014年1月至2016年4月在一家三级产科和创伤中心进行的单中心回顾性研究，纳入因腹部创伤入院的孕妇。采用加拿大妇产科学会指南评估创伤严重程度。分析KB试验阳性（定义为>0.1%）的影响。不良结局定义为以下一种或多种并发症：宫内胎儿死亡、胎盘早剥、孕周<37周的早产以及胎儿或新生儿贫血。
研究期间，纳入265例涉及腹部创伤的妊娠病例：69%为轻度创伤，31%为重度创伤。所有患者中，5.6%的KB试验呈阳性，其中15.4%出现不良结局。在总体人群（P=0.16）、轻度创伤人群（P=1）或重度创伤人群（P=0.14）中，KB试验阳性组和阴性组的不良结局发生率均无显著差异。总体人群、轻度创伤组和重度创伤组的预测阳性值分别为15.4%、0%和25%。
孕期创伤时，KB试验似乎对定义不良结局并无帮助。
