From the Division of Trauma and Surgical Critical Care, LAC+USC Medical Center, University of Southern California, Los Angeles, California.
J Trauma Acute Care Surg. 2021 May 1;90(5):861-865. doi: 10.1097/TA.0000000000003093.
Motor vehicle crashes (MVCs) are a leading cause of death in pregnant women. Even after minor trauma, there is risk of fetal complications. The purpose of this study was to compare injuries and outcomes in pregnant with matched nonpregnant women after MVC and evaluate the incidence and type of pregnancy-related complications.
Retrospective study at a Level I trauma center included pregnant MVC patients, admitted 2009 to 2019. Pregnant patients were matched for age, seatbelt use, and airbag deployment with nonpregnant women (1:3). Gestation-related complications included uterine contractions, vaginal bleeding, emergency delivery, and fetal loss.
During the study period, there were 6,930 MVC female admissions. One hundred forty-five (2%) were pregnant, matched with 387 nonpregnant. The seat belt use (71% in nonpregnant vs. 73% in pregnant, p = 0.495) and airbag deployment (10% vs. 6%, p = 0.098) were similar in both groups. Nonpregnant women had higher Injury Severity Score (4 vs. 1, p < 0.0001) and abdominal Abbreviated Injury Scale (2 vs. 1, p < 0.001), but a smaller proportion sustained abdominal injury (18% vs. 53%, p < 0.0001). Mortality (1% vs. 0.7%, p = 0.722), need for emergency operation (6% vs. 3%, p = 0.295) or angiointervention (0.3% vs. 0%, p = 0.540), ventilator days (3 vs. 8, p = 0.907), and intensive care unit (4 vs. 4, p = 0.502) and hospital length of stay (2 vs. 2, p = 0.122) were all similar. Overall, 13 (11.1%) patients developed gestation-related complications, most commonly uterine contractions (6.3%), need for emergency delivery (3.5%), and vaginal bleeding (1.4%).
Most pregnant patients hospitalized for MVC suffered minor injuries. Pregnant women had lower Injury Severity Score and abdominal Abbreviated Injury Scale than matched nonpregnant women. However, there was still a considerable incidence of gestation-related complications. It is imperative that pregnant patients be closely monitored even after minor trauma.
Prognostic and epidemiological, level III.
机动车事故（MVC）是孕妇死亡的主要原因。即使是轻微创伤，也存在胎儿并发症的风险。本研究的目的是比较 MVC 后孕妇与匹配的非孕妇的损伤和结局，并评估与妊娠相关的并发症的发生率和类型。
这是一项在一级创伤中心进行的回顾性研究，纳入了 2009 年至 2019 年期间因 MVC 住院的孕妇患者。将孕妇患者按年龄、安全带使用情况和安全气囊展开情况与非孕妇患者（1:3）进行匹配。妊娠相关并发症包括子宫收缩、阴道出血、紧急分娩和胎儿丢失。
在研究期间，有 6930 名 MVC 女性入院。145 名（2%）为孕妇，与 387 名非孕妇相匹配。非孕妇安全带使用率（71%比孕妇的 73%，p = 0.495）和安全气囊展开率（10%比孕妇的 6%，p = 0.098）相似。非孕妇的损伤严重程度评分（4 分比孕妇的 1 分，p < 0.0001）和腹部损伤严重程度评分（2 分比孕妇的 1 分，p < 0.001）更高，但腹部损伤的比例较小（18%比孕妇的 53%，p < 0.0001）。死亡率（1%比孕妇的 0.7%，p = 0.722）、需要紧急手术（6%比孕妇的 3%，p = 0.295）或血管内介入治疗（0.3%比孕妇的 0%，p = 0.540）、呼吸机使用天数（3 天比孕妇的 8 天，p = 0.907）、重症监护病房（4 天比孕妇的 4 天，p = 0.502）和住院时间（2 天比孕妇的 2 天，p = 0.122）相似。总体而言，13 名（11.1%）患者发生了与妊娠相关的并发症，最常见的是子宫收缩（6.3%）、需要紧急分娩（3.5%）和阴道出血（1.4%）。
因 MVC 住院的大多数孕妇患者受的都是轻伤。与匹配的非孕妇相比，孕妇的损伤严重程度评分和腹部损伤严重程度评分较低。然而，与妊娠相关的并发症仍有相当高的发生率。即使是轻微创伤，也必须密切监测孕妇患者。
预后和流行病学，III 级。
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