MOTOR-VEHICLE ACCIDENT DURING THE 2ND-TRIMESTER OR 3RD-TRIMESTER OF PREGNANCY

Objective. To evaluate the need of immediate treatment, follow-up and consequences of different types of traffic accidents during pregnancy. Method and material. A retrospective analysis covering five years inv olving thirty-five pregnant women involved in motor vehicle accidents at 22-39 weeks of gestation. Results. Fifteen of the 35 women were inv olved in frontal impact collisions, and suffered mild subjective and o bjective symptoms; all their fetuses survived and were delivered at te rm. Fifteen other women were involved in broadside collisions; two of these were riding a bicycle. These 15 women had clear objective findin gs like uterine contractions or tenderness, and some of them needed to colytic therapy and hospitalization up to eight days. This was signifi cantly longer than in those involved in frontal impact collisions. How ever, the broadside accidents did not have any adverse effect on pregn ancy outcomes either. Five women were involved in serious accidents at speeds of 80-110 km/h, and one mother and her fetus died immediately because of rupture of the uterus and the cervical joint and spinal can al. Four other fetuses were found dead on arrival at hospital or soon after. In all cases the cause of fetal loss was placental abruption. T he presence of fetal blood cells in maternal blood was evaluated in 15 of 35 patients, but was positive in only one. Conclusion. Frontal col lisions are associated with lower vehicular speed, less trauma and no acute or later effects on pregnancy, whereas broadside collisions and high speed (>80km/h) cause more symptoms. The latter type of accidents are associated with high risk of placental abruption and of fetal and maternal death. Fortunately the symptoms are evident immediately afte r the accident, and early hospital discharge is possible if no abnorma lities are present during the first hours.