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Trauma in pregnancy: an updated systematic review

  • Hector Mendez-Figueroa
    Correspondence
    Reprints: Hector Mendez-Figueroa, MD, Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, 101 Plain St., 7th Floor, Providence, RI 02903
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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  • Joshua D. Dahlke
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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  • Roxanne A. Vrees
    Affiliations
    Division of Emergency Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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  • Dwight J. Rouse
    Affiliations
    Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants' Hospital, Warren Alpert Medical School of Brown University, Providence, RI
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Published:January 21, 2013DOI:https://doi.org/10.1016/j.ajog.2013.01.021
      We reviewed recent data on the prevalence, risk factors, complications, and management of trauma during pregnancy. Using the terms “trauma” and “pregnancy” along with specified mechanisms of injury, we queried the PubMed database for studies reported from Jan. 1, 1990, through May 1, 2012. Studies with the largest number of patients for a given injury type and that were population-based and/or prospective were included. Case reports and case series were used only when more robust studies were lacking. A total of 1164 abstracts were reviewed and 225 met criteria for inclusion. Domestic violence/intimate partner violence and motor vehicle crashes are the predominant causes of reported trauma during pregnancy. Management of trauma during pregnancy is dictated by its severity and should be initially geared toward maternal stabilization. Minor trauma can often be safely evaluated with simple diagnostic modalities. Pregnancy should not lead to underdiagnosis or undertreatment of trauma due to unfounded fears of fetal effects. More studies are required to elucidate the safest and most cost-effective strategies for the management of trauma in pregnancy.

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