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妊娠期骨盆骨折:多学科管理与治疗结果

Pelvic Fractures in Pregnancy: Multidisciplinary Management and Outcomes.

作者信息

Sevgi Kaan, Pliskow Steven, Aran Sinan Nazif

机构信息

School of Medicine, Kansas City University of Medicine and Biosciences, Kansas City, USA.

Department of Obstetrics and Gynecology, HCA Florida Palms West Hospital, West Palm Beach, USA.

出版信息

Cureus. 2025 May 27;17(5):e84898. doi: 10.7759/cureus.84898. eCollection 2025 May.

Abstract

Pelvic fractures during pregnancy, though rare, pose significant risks to maternal and fetal health, necessitating a multidisciplinary approach to management. These injuries are predominantly caused by high-energy trauma, such as motor vehicle accidents, and are associated with a high incidence of complications, including maternal hemorrhage, placental abruption, and preterm labor. Advances in diagnostic imaging, such as low-dose CT scans and MRIs, have improved diagnostic accuracy while minimizing fetal exposure to radiation. Similarly, biomechanically tailored surgical interventions and innovative treatment strategies, including minimally invasive fixation techniques, have enhanced maternal survival rates, reaching 95% when multidisciplinary care is implemented. Despite these advancements, challenges persist, particularly in resource-limited settings where disparities in access to care result in poorer outcomes. Ethical and medico-legal considerations further complicate management, emphasizing the importance of informed consent and balancing maternal autonomy with fetal well-being. This review highlights the critical role of public health initiatives, such as trauma prevention campaigns, and the need for innovation in diagnostics, therapeutics, and long-term care. Future research should prioritize addressing gaps in our understanding of long-term maternal and neonatal outcomes, particularly regarding reproductive health and quality of life. By integrating advanced technologies, fostering collaboration, and improving global access to care, clinicians can achieve optimal outcomes for both mother and child.

摘要

孕期骨盆骨折虽罕见,但对母婴健康构成重大风险,因此需要多学科管理方法。这些损伤主要由高能创伤引起,如机动车事故,且并发症发生率高,包括母体出血、胎盘早剥和早产。诊断成像技术的进步,如低剂量CT扫描和MRI,提高了诊断准确性,同时将胎儿暴露于辐射的风险降至最低。同样,生物力学定制的手术干预和创新治疗策略,包括微创固定技术,提高了产妇生存率,实施多学科护理时生存率可达95%。尽管取得了这些进展,但挑战依然存在,尤其是在资源有限的环境中,获得护理的差异导致结果较差。伦理和医学法律考虑使管理更加复杂,强调了知情同意以及平衡产妇自主权与胎儿健康的重要性。本综述强调了公共卫生举措(如创伤预防运动)的关键作用,以及在诊断、治疗和长期护理方面进行创新的必要性。未来的研究应优先解决我们对长期母婴结局认识上的差距,特别是在生殖健康和生活质量方面。通过整合先进技术、促进合作以及改善全球医疗服务可及性,临床医生可为母婴实现最佳结局。

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