Jafari Kafiabadi Meisam, Sabaghzadeh Amir, Khabiri Seyyed Saeed, Sadighi Mehrdad, Mehrvar Amir, Biglari Farsad, Ebrahimpour Adel
Department of Orthopedics Surgery, Shohada-e Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Orthopedics Surgery, Taleghani Hospital Research Development Committee, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Arch Acad Emerg Med. 2022 May 18;10(1):e39. doi: 10.22037/aaem.v10i1.1573.. eCollection 2022.
Blunt traumas, like road accidents and falls, are common causes of injuries to pregnant women, and the major risk factors are young age and low socioeconomic level. Due to physiological and anatomical changes specific to pregnancy, such as changes in blood pressure and hemoglobin drop, trauma management involves certain complexities. Physical trauma is estimated to cause at least 1 complication in every 12 pregnancies. This study aims to evaluate orthopedic trauma during pregnancy and appreciate the different approaches to circumvent the resultant challenges.
We reviewed 55 articles, published on orthopedic trauma during pregnancy between 2011 and 2021. The articles were identified by searching PubMed, google-scholar, Scopus, and Science-Direct. We utilized the search terms: fall in pregnancy, traumas in pregnancy, motor vehicle accident/crash in pregnancy, blunt trauma in pregnancy, pregnant trauma patient, penetrating injury during pregnancy, assault, interpersonal violence in pregnancy, and mortality and pregnancy.
According to available reports, after stabilizing the pregnant patient, diagnostic procedures, including radiography, and even gadolinium-based techniques when needed, can be performed to examine extensive trauma. In contrast to elective orthopedic surgery, emergency orthopedic surgeries, including reduction of open fractures, should be performed promptly.
Based on our investigation, pregnant women with orthopedic injuries that are severe, or even seemingly less severe, experience significantly increased adverse pregnancy outcomes, which include preterm birth, placental abruption, poor infant condition at birth, infant death, and even maternal death.
钝性创伤,如交通事故和跌倒,是孕妇受伤的常见原因,主要风险因素是年轻和社会经济水平低。由于怀孕特有的生理和解剖变化,如血压变化和血红蛋白下降,创伤处理涉及一定的复杂性。据估计,身体创伤在每12次怀孕中至少会导致1种并发症。本研究旨在评估孕期骨科创伤,并了解应对由此产生的挑战的不同方法。
我们回顾了2011年至2021年间发表的55篇关于孕期骨科创伤的文章。通过搜索PubMed、谷歌学术、Scopus和科学直投来识别这些文章。我们使用的搜索词包括:孕期跌倒、孕期创伤、孕期机动车事故/碰撞、孕期钝性创伤、孕期创伤患者、孕期穿透伤、袭击、孕期人际暴力以及死亡率与怀孕。
根据现有报告,在稳定孕妇病情后,可以进行包括放射摄影在内的诊断程序,甚至在需要时进行基于钆的技术检查,以检查广泛的创伤。与择期骨科手术不同,急诊骨科手术,包括开放性骨折复位,应立即进行。
根据我们的调查,患有严重或甚至看似不太严重骨科损伤的孕妇,不良妊娠结局显著增加,包括早产、胎盘早剥、出生时婴儿状况不佳、婴儿死亡,甚至产妇死亡。