Trauma in pregnancy: An analysis of the adverse perinatal outcomes and the injury severity score

BACKGROUND: Trauma during pregnancy is one of the most important causes of non-obstetric maternal and fetal mortality and morbidity. The aim of our study is to evaluate the adverse perinatal outcomes that may occur according to the type and severity of the trauma.
METHODS: In this retrospective cohort study, pregnant traumatized women aged 18–50 years and referred for consultation to the Prof. Dr. Cemil Tascýoglu City Hospital’s emergency services of the departments of gynecology and obstetrics, between January 1, 2017, and December 31, 2022, were evaluated. Demographic characteristics, trauma findings, Injury Severity Scoring (ISS), and obstet-ric outcomes were recorded.
RESULTS: A total of 1825 trauma patients, including 900 pregnants were referred to our emergency gynecology clinic for consulta-tion. One hundred and fifty three pregnant patients, whose birth information we reached, were selected as the study group. The mean age of the patients was 25.56±5.99 years and the mean gestational week at the time of trauma was 21.59±9.89 weeks, the patients had fallen (67.97%), had been exposed to violence (30.07%), and had a traffic accient (1.96%). The patient’s delivery and hospitalization status on the day of trauma, fracture and ISS ≥9 were statistically significantly at a higher rate in the 3rd trimester. Rates of hospitaliza-tion and 3rd trimester traumas were found to be significantly higher in the ISS ≥9 group. (P=0.0001, P=0.028, respectively).
CONCLUSION: Compared to the general population, the rates of preterm premature rupture of membranes-premature rupture of membranes, fetal death, fetal distress, cesarean delivery, placental abruption, and preterm delivery increased in traumatized pregnant women. Patients with low ISS scores should also be followed closely during pregnancy in terms of perinatal complications, as well as the severe trauma group.

Gebelikte travma: Olumsuz perinatal sonuçlar ve yaralanma þiddet puanýnýn analizi

AMAÇ: Gebelikte travma, obstetrik olmayan maternal ve fetal mortalite ve morbiditenin en önemli nedenlerinden biridir. Çalýþmamýzýn amacý travmanýn tipine ve þiddetine göre oluþabilecek olumsuz perinatal sonuçlarý deðerlendirmektir.
GEREÇ VE YÖNTEM: Bu retrospektif kohort çalýþmada, 1 Ocak 2017 ile 31 Aralýk 2022 tarihleri arasýnda Prof. Dr. Cemil Taþçýoðlu Þehir Hastanesi Kadýn Hastalýklarý ve Doðum acil servislerine konsültasyon için baþvuran 18-50 yaþ arasý travma geçirmiþ gebeler deðerlendirildi. Demografik özel-likler, travma bulgularý, Yaralanma Þiddet Skorlamasý ve obstetrik sonuçlar kaydedildi.
BULGULAR: 900'ü gebe olmak üzere toplam 1825 travma hastasý konsültasyon için acil jinekoloji kliniðimize sevk edildi. Doðum bilgilerine ulaþtýðý-mýz 153 gebe hasta çalýþma grubu olarak seçildi. Hastalarýn yaþ ortalamasý 25.56±5.99 yaþ, travma geçirdiði gebelik haftasý ortalamasý 21.59±9.89 hafta idi. Hastalarda %67.97 düþme, %30.07 þiddet ve darp ve %1.96 trafik kazasý izlendi. Travma günü doðum oranlarý, hospitalizasyon durumlarý, ISS ≥9 ve kýrýk varlýðý 3. Trimestrde anlamlý olarak yüksek bulundu. Hospitalizasyon ve 3. Trimester travmalarý ISS ≥9 grubunda anlamlý olarak daha fazla görülmekteydi. (p=0.0001, p=0.028 ).
SONUÇ: Genel popülasyonla karþýlaþtýrýldýðýnda, travma geçirmiþ gebelerde PPROM-PROM, fetal ölüm, fetal distres, sezaryen doðum, plasenta dekolmaný ve erken doðum oranlarý artmýþtýr. ISS skoru düþük olan hastalar da, ciddi travma hastalarý gibi gebelik döneminde perinatal komplikas-yonlar açýsýndan yakýndan izlenmelidir.