Department of Obstetrics and Gynecology, University of Arizona College of Medicine, Banner University Medical Center, Phoenix, AZ.
Department of Surgery, University of Arizona College of Medicine, Banner University Medical Center, Phoenix, AZ.
Semin Perinatol. 2018 Feb;42(1):13-20. doi: 10.1053/j.semperi.2017.11.004.
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6-8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize that even minor mechanisms of injury may result in poor outcomes for both fetus and mother. Injured pregnant patients meeting admission criteria experience a progressive increase in the number of complications as well as the number of patients that require delivery. There exists opportunity to identify patients who require admission and provide supportive measures that may reduce the complications of prematurity. Patients that are admitted may benefit from a multidisciplinary approach including on-going care from obstetricians or maternal-fetal medicine physicians. Placental abruption is the most common pregnancy complication, and may occur with even minor mechanisms of injury. Increasing severity of trauma increases the frequency of abruption, admission, delivery, and fetal demise.
创伤是妊娠期间非产科死亡的主要原因,大约有 6-8%的妊娠因意外或故意受伤而变得复杂。受伤孕妇的初步评估和管理通常需要多学科、协作的团队,为母亲和胎儿提供最佳结果。重要的是要认识到,即使是轻微的损伤机制也可能导致胎儿和母亲的不良结局。符合入院标准的受伤孕妇,其并发症的数量以及需要分娩的患者数量都会逐渐增加。有机会识别需要入院的患者,并提供支持性措施,以减少早产的并发症。入院的患者可能受益于多学科方法,包括产科医生或母胎医学医生的持续护理。胎盘早剥是最常见的妊娠并发症,即使是轻微的损伤机制也可能发生。创伤严重程度的增加会增加胎盘早剥、入院、分娩和胎儿死亡的频率。