Does the minor trauma during pregnancy have any effect on perinatal outcome?

Year 2015, Volume: 42 Issue: 4, 410 - 415, 08.01.2016

Neslihan Yerebasmaz , Derya Cırık Şirin Aydın Mualla Koçer Fulya Kayıkçıoğlu Leyla Mollamahmutoğlu

Abstract

Objective: Women having major trauma during pregnancy are at increased risk for both maternal and fetal morbidity. However, the association between minor trauma and adverse perinatal outcomes is still unknown. Therefore, we aimed to analyze the incidence of minor trauma in pregnancy and effect on the outcomes of pregnancy.

Methods: The data of patients, who were admitted to the emergency service of Etlik Zübeyde Hanım Women’s Health Training and Research Hospital between January 2013 and December 2014, were evaluated. A total of 283 patients (0.3%), who had minor trauma during pregnancy, were included in the study. Demographic and obstetric data were analyzed with descriptive statistics. Additionally, antenatal complications and pregnancy outcomes were evaluated in 188 patients, who were followed during pregnancy and delivered their babies at our hospital

Results: During the study period, of 105,727 women who were admitted to the emergency service of our hospital, 283 (0.3%) had minor trauma during pregnancy. The causes of minor trauma, in order of frequency, included home accidents (81.3%), domestic violence (9.9%) and traffic accidents (8.8%). Preterm delivery has been the most frequently antenatal complication observed in these patients (15.4%).

Conclusion: Home accidents and domestic violence are the most common causes of minor trauma during pregnancy, and the patients are particularly at risk during the second trimester. The patients must be cautioned regarding the risk of preterm delivery and advised to attend regular pregnancy follow-up visits due to the fact that these patients have a higher risk of preterm delivery.

Key words: Minor trauma, pregnancy, antenatal complication, preterm delivery

Keywords

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Gebelikteki minör travmanın gebelik sonuçlarına etkisi var mı?

Abstract

Amaç: Gebeliğinde major travma yaşayan kadınlarda hem maternal hem de fetal mortalite artmıştır. Ancak gebelikteki minör travma ile kötü perinatal sonuçlar arasında ilişki olup olmadığı bilinmemektedir. Bu çalışmada gebelikte minör travmaya maruz kalma sıklığı ve gebelikte minör travmaya maruziyetin gebelik sonuçlarına etkisi araştırıldı.Yöntemler: Ocak 2013-Aralık 2014 tarihleri arasında Etlik Zübeyde Hanım Kadın Hastalıkları Eğitim Araştırma Hastanesi kadın doğum acil servisine başvuran 105727 hasta verisi incelendi. Hastalardan gebe olan ve gebeliğinde minör travma öyküsü olan 283 (%0,3) gebe çalışmaya dahil edildi. Gebelerin demografik özellikleri tanımlayıcı istatistiksel yöntemlerle belirlendi. Çalışma grubumuzdaki gebelerden hastanemizde takip edilen ve doğum yapan 188 hastanın bilgilerine ulaşıldı. Bu gebelerin antenatal komplikasyonlar ve gebelik sonuçları incelendi.Bulgular: Çalışma periyodunda hastanemiz acil servisine başvuran 105727 kadından 283’ü (%0,3) gebe ve acile başvuru nedeni minör travma idi. Sıklık sırasına göre minör travmalar ev içi kazalar (%81,3), aile içi şiddet (%9,9) ve trafik kazaları (%8,8) olarak bulundu. Bu gebelerden hastanemizde takip edilen ve doğuran 188 hastanın verileri incelendiğinde en sık saptanan komplikasyon preterm doğum olarak bulundu (%15,4).Sonuç: Ev içi kazalar ve aile içi şiddet gebelikte minör travmaların en sık nedenleridir. Gebelerde özellikle 2. trimesterde minör travma riski daha fazla bulunmuştur. Gebeliği sırasında minör travmaya maruz kalan gebelerde preterm doğum riski artmıştır. Bu gebeler preterm eylem ve doğum riski konusunda bilgilendirilmeli ve gebelik takiplerini daha dikkatli yaptırmaları önerilmelidir

Keywords

Gebelik, minör travma, antenatal komplikasyon, preterm doğum

References

• Cannada LK, Pan P, Casey BM, et al. Pregnancy outcomes after orthopedic trauma. J Trauma 2010; 69:694–698.
• Grossman NB. Blunt trauma in pregnancy. Am Fam Physician
• ; 70:1303-1310.
• Murphy NJ, Quinlan JD. Trauma in pregnancy: assessment,
• management, and prevention. Am Fam Physician 2014;10:717-722.
• Mendez-Figueroa H, Dahlke JD, Vrees RA, Rouse DJ. Trauma in pregnancy: an updated systematic review. Am J Obstet Gynecol 2013; 209:1- 10.
• Cahill AG, Bastek JA, Stamilio DM, et al. Minor trauma in pregnancy—is the evaluation unwarranted? Am J Obstet Gynecol. 2008; 198:208.e1-5.
• Hyde LK, Cook LJ, Olson LM, et al. Effect of motor vehicle crashes on adverse fetal outcomes. Obstet Gynecol 2003;102:279-286.
• Mattox KL, Goetzl L. Trauma in pregnancy. Crit Care Med 2005; 33:S385–389.
• Cheng HT, Wang YC, Lo HC, et al. Trauma during pregnancy: a population-based analysis of maternal outcome. World Journal of Surgery 2012; 36:2767-2775.
• Chames MC, Pearlman MD. Trauma during pregnancy: Outcomes and clinical management. Clin Obstet Gynecol 2008:51,398-408.
• Garcia-Moreno C, Jansen HA, Ellsberg M, et al. WHO Multi-country Study on Women’s Health and Domestic Violence against Women Study Team. Prevalence of intimate partner violence: findings from the WHO multi-country study on women’s health and domestic violence. Lancet 2006; 368:1260–1269.
• Campbell J, García-Moreno C, Sharps P. Abuse during pregnancy in industrialized and developing countries. Violence Women 2004; 10:770–789.
• Shamu S, Abrahams N, Temmerman M, et al. A systematic
• review of African studies on intimate partner violence against pregnant women: prevalence and risk factors. PLoS One 2011; 6:e1759.
• Ellsberg M. Violence against women and the Millennium
• Development Goals: facilitating women’s access to support. Int J Gynecol Obstet 2006; 94:325–332.
• Lisonkova S, Joseph KS. Incidence of preeclampsia: risk factors and outcomes associated with early- versus lateonset disease. Am J Obstet Gynecol. 2013; 209:544.e1-12.
• Garmi G, Marjieh M, Salim R. Does minor trauma in pregnancy
• affect perinatal outcome? Arch Gynecol Obstet. 2014; 290:635-641.
• Lawn JE, Blencowe H, Oza S, et al. Every newborn: progress,
• priorities, and potential beyond survival. Lancet 2014;384:189–205.
• Fischer PE, Zarzaur BL, Fabian TC, et al. Minor trauma is an unrecognized contributor to poor fetal outcomes: a population-based study of 78,552 pregnancies. Journal of Trauma and Acute Care Surgery 2011; 71:90-93.
• El-Kady D, Gilbert WM, Anderson J, et al. Trauma during pregnancy: an analysis of maternal and fetal outcomes in alarge population. Am J Obstet Gynecol 2004; 190:1661–1668.
• Zangene M, Ebrahim B, Najafi F. Trauma in pregnancy and its condequences in Kermanshah, Iran From 2007-2010. Glob J Health Sci, 2014; 7:304-309.
• Han A, Stewart DE. Maternal and fetal outcomes of intimate partner violence associated with pregnancy in the Latin American and Caribbean region. Int J Gynecol and Obstet 2014; 124:6–11
• Rodrigues T, Rocha L, Barros H. Physical abuse during
• pregnancy and preterm delivery. Am J Obstet and Gynecol
• ; 198:171.e1–e6.
• Valladares E, Ellsberg M, Pena R, et al. Physical partner abuse during pregnancy: a risk factor for low birth weight in Nicaragua. Obstet Gynecol 2002; 100:700–705.
• Alio AP, Nana PN, Salihu HM. Spousal violence and potentially
• preventable single and recurrent spontaneous fetal loss in an African setting: cross-sectional study. Lancet 2009; 373:318–324.
• Romero-Guttiérrez G, Cruz-Arvizu VH, Regalado-Cedillo CA, Ponce-Ponce de León AL. Prevalence of violence against pregnant women and associated maternal and neonatal complication in Leon, Mexico. Midwifery 2011;27:750–753.
• Cengiz H, Kanawati A, Yıldız Ş, et al. Domestic violence against pregnant women: A prospective study in a metropolitan city, İstanbul. J Turk Ger Gynecol Assoc 2014;15:74-77.
• Arslantas H, Adana F, Ergin F, et al. Domestic violence during
• pregnancy in an eastern city of Turkey: a field study. J Interpers Violence 2012; 27:1293-1313.
• Hamilton BE, Martin JA, Ventura SJ. Births: preliminary data from 2011. Natl Vital Stat Rep. 2012; 61:1-18.
• Chang HH, Larson J, Blencowe H, et al. Preventing preterm births: analysis of trends and potential reductions with interventions
• in 39 countries with very high human development index. Lancet 2013; 381:223–234.
• Onat T, Abalı R, Turgut NE, et al. 10-15 ve 20-25 Haftalarda
• ölçülen servikal uzunluğunun preterm doğumu öngörmedeki yeri. İstanbul Medical Journal 2014; 15:35-39.
• Pool MS, Otupiri E, Owusu-Dabo E, et al. Physical violence during pregnancy and pregnancy outcomes in Ghana BMC Pregnancy and Childbirth 2014;14:71.