Predictors of outcome in trauma during pregnancy: Identification of patients who can be monitored for less than 6 hours

Background: The first objective of this study was to identify risk factors in pregnant patients suffering blunt trauma predictive for uterine contract ions, preterm labor, or fetal loss. The second objective was to identify pa tients who can safety undergo fetal monitoring for 6 hours or less after bl unt trauma by selecting out those patients demonstrating the identified ris k factors. Methods: A retrospective chart review was performed from January 1, 1990, t hrough December 31, 1998, Charts were reviewed for numerous possible risk f actors for adverse outcomes. Statistical analysis was performed by using lo gistic regression. Results: A total of 271 pregnant patients admitted after blunt trauma were identified. Risk factors significantly predictive of fetal death included e jections, motorcycle and pedestrian collisions, maternal death, maternal ta chycardia, abnormal fetal heart rate, lack of restraints, and Injury Severi ty Score > 9, Risk factors significantly predictive of contractions or pret erm labor included gestational age > 35 weeks, assaults, and pedestrian col lisions. Conclusion: Pregnant patients who present after blunt trauma with any of th e identified risk factors for contractions, preterm labor, or fetal loss sh ould be monitored for at least 24 hours. Patients without these risk factor s can safely be monitored for 6 hours after trauma before discharge.