Objective: To study the outcome of pelvic fractures and fetuses in pregnant
patients involved in blunt multiple trauma.
Design: Retrospective follow-up study.
Setting: Level I trauma center.
Patients: Pregnant multiple trauma patients with pelvic fractures between 1
974 and 1998.
Interventions: Conservative and operative treatment of pelvic fractures ada
pted to the clinical status of the mother.
Main Outcome Measures: Clinical, functional, and social outcomes were evalu
ated.
Results: Out of 4,196 patients with blunt multiple trauma treated between 1
974 and June 1998, seven demonstrated the combination of blunt multiple tra
uma, pregnancy, and pelvic fractures. These patients had a mean Injury Seve
rity Score of 29.9 points. Five mothers and three fetuses survived their in
juries. All dead fetuses died on the scene. One surviving fetus was found t
o have hydrocephalus unrelated to the injury; the remaining fetuses had an
uneventful delivery and were healthy. In two of the three patients whose fe
tuses survived, the treatment of the pelvic fracture was modified for the s
ake of fetal well-being. In all of these patients, acceptable outcome was a
chieved.
Conclusion: Modification of the treatment of the pelvic fracture in pregnan
t women with multiple trauma may be necessary to minimize the risk of fetal
injury. In our experience with these rare cases, this modified treatment d
id not severely alter the clinical outcome of the mother's pelvic fracture.