The outcome of blunt abdominal trauma preceding birth.

摘要

OBJECTIVE: The purpose of this study was to examine the outcome of pregnancies in women suffering blunt abdominal trauma, which preceded birth. METHODS: A retrospective cohort study was performed comparing patients who did and did not suffer blunt abdominal trauma preceding birth. Deliveries occurred during the years 1988-2002 in a tertiary medical center. Data regarding abdominal trauma that led to birth was available from the perinatal database of the center. Stratified analysis, using a multiple logistic regression model, was performed to control for confounders. RESULTS: Fifty-four cases of blunt abdominal trauma leading to birth were identified out of 159,223 deliveries that occurred during the study period. Using a multivariate analysis, with backward elimination, placental abruption (OR = 10.0; 95% CI 3.9-25.5; P < 0.001) and preterm delivery (OR = 2.5; 95% CI 1.3-5.0; P = 0.008) were found to be significantly associated with blunt abdominal trauma. A higher rate of Cesarean deliveries was notedamong women suffering abdominal trauma (24.1% vs. 12.2%, P = 0.019). No significant differences were found regarding the perinatal outcome between women who did and did not suffer abdominal trauma, as demonstrated by an Apgar score of less than seven at one (7.4% vs. 4.5%, P = 0.30) and five minutes (1.9% vs. 0.6%, P = 0.28) and by perinatal mortality rates (3.7% vs. 1.5%, P = 0.19). CONCLUSION: Blunt abdominal trauma was significantly associated with placental abruption and preterm delivery. However, the perinatal outcome of these pregnancies was not significantly different from that of the general population.