Citation

Luley T, Fitzpatrick CB, Grotegut CA, Hocker MB, Myers ER, Brown HL. Am. J. Obstet. Gynecol. 2013; 208(6): 466.e1-4665.

Affiliation

Department of Obstetrics and Gynecology, Duke University Medical Center, Durham, NC.

Copyright

(Copyright © 2013, Elsevier Publishing)

DOI

10.1016/j.ajog.2013.02.032

PMID

23439323

Abstract

OBJECTIVE: To examine the association between restraint use, race and perinatal outcome after motor vehicle accidents during pregnancy. STUDY DESIGN: The Duke Trauma Registry and medical records were queried for pregnant women > 14 weeks involved in a motor vehicle accident (MVA) and received care through the Emergency Department and the Obstetric Units. Between January 1994 and December 31, 2010, 126 women were identified. Variables collected included type of trauma, gestational age at presentation and delivery outcomes. A prognostic study was performed evaluating the associations between maternal demographics, details of the accident including restraint use, and maternal treatment related to the accident in relationship to perinatal outcome. RESULTS: There was no difference in the mean age or median gravidity or parity by race among pregnant women cared for following an MVA. There was no difference in mean age or racial distribution between women who were restrained compared to those unrestrained except unrestrained women were more likely to be nulliparous. Unrestrained women were more likely to require non-obstetrical surgery related to the trauma. The overall rate of placental abruption was six percent. There were six intrauterine fetal demises, three each in the unrestrained (25%) and restrained groups (3.5%), respectively, (p = 0.018). Airbags deployed in 17 accidents. Among the seven women with placenta abruption, 4 (57%) had air bag deployment. CONCLUSION: Lack of restraint use during pregnancy is associated with an increased risk of fetal death.

Language: en