Department of Preventive Services, Kyoto University School of Public Health, Kyoto, Japan.
Critical Care and Trauma Center, Osaka General Medical Center, 3-1-56 Bandaihigashi Sumiyoshi-Ku, Osaka, 558-8558, Japan.
Eur J Trauma Emerg Surg. 2023 Jun;49(3):1287-1293. doi: 10.1007/s00068-022-02165-w. Epub 2022 Nov 17.
Trauma during pregnancy is the leading indirect obstetric cause of death, and its management is challenging owing to its characteristics. We aimed to describe the epidemiology of pregnant trauma patients and explore their characteristics by comparing them with those of non-pregnant patients.
Using the Japan Trauma Data Bank data collected between January 2004 and May 2019, we identified pregnant and non-pregnant female trauma patients between the ages of 15-45 years. We described patient characteristics, prehospital information, in-hospital management, and clinical outcomes. We also investigated the differences in the information between pregnant and non-pregnant patients.
In total, 165 pregnant trauma patients were identified (0.7%). Motor vehicle collisions were the most frequent mechanism of injury (64.6%) in pregnant patients. The time from call to the arrival of emergency medical services at the hospital was similar for both pregnant and non-pregnant patients. The use of abdominal computed tomography (CT) scans was lower and injury to the abdomen was more frequent in pregnant than non-pregnant patients. In-hospital mortality was 7.2% in pregnant patients and 10.9% in non-pregnant patients. No significant differences in mortality after adjustment for confounding factors were found (adjusted odds ratio: 0.78, 95% confidential interval: 0.35-1.75, p = 0.548).
Transport time and mortality were similar between pregnant and non-pregnant trauma patients. Abdominal trauma and surgery were more common in pregnant relative to non-pregnant patients, while the number of CT scans was less. Further research is required to investigate the effects of trauma on the course of pregnancy and the fetus.
妊娠相关创伤是导致产妇间接死亡的首要原因，由于其具有特殊性，其处理极具挑战性。本研究旨在通过与非妊娠患者进行比较，描述妊娠创伤患者的流行病学特征并探讨其特点。
我们使用日本创伤数据库（Japan Trauma Data Bank）2004 年 1 月至 2019 年 5 月间收集的数据，确定了年龄在 15-45 岁之间的妊娠和非妊娠女性创伤患者。我们描述了患者特征、院前信息、院内管理和临床结局。我们还调查了妊娠和非妊娠患者信息之间的差异。
共纳入 165 例妊娠创伤患者（0.7%）。机动车碰撞是妊娠患者最常见的损伤机制（64.6%）。从呼救到急救医疗服务到达医院的时间在妊娠和非妊娠患者之间相似。妊娠患者中腹部计算机断层扫描（CT）检查的使用率较低，腹部损伤更为常见。妊娠患者的院内死亡率为 7.2%，非妊娠患者为 10.9%。在校正混杂因素后，死亡率无显著差异（校正比值比：0.78，95%置信区间：0.35-1.75，p=0.548）。
妊娠和非妊娠创伤患者的转运时间和死亡率相似。与非妊娠患者相比，妊娠患者更常见腹部创伤和手术，而 CT 扫描的数量更少。需要进一步研究来探讨创伤对妊娠和胎儿的影响。
