An Analysis of Outcomes After Trauma in Obstetric Patients

Abstract

Traumatic injury in obstetric patients has been shown to correlate with adverse fetal outcomes; however, data predates modern resuscitation and imaging techniques. A single center retrospective review was performed analyzing risk factors for obstetric outcomes for pregnant patients seen at a Level 1 Trauma Center from 2010 to 2020. 571 pregnant patients were compared to nonpregnant child-bearing age women. Injury Severity Scores (ISS) were higher in nonpregnant patients (5 vs 0, P < .001), with similar mortality (P = .07). 558 (98%) injured pregnant patients had an ISS < 9. 122 (21%) pregnant patients suffered obstetric or fetal complications, had higher ISS (P < .001), higher abbreviated injury scales (AIS) for thorax, abdomen, spine, lower extremities (P < .05), and lower gestational age (P = .005). Age, Glasgow Coma Score (GCS), AIS Abdomen and Lower Extremity, and preterm pregnancy were predictive of adverse outcomes. Non-caucasian race, higher gestational age, and term pregnancy were predictive of labor during admission.

Keywords: pregnancy; trauma.