Trauma in Pregnancy: A 5-Year Multi-Centre Retrospective Registry Analysis in South Australia.

OBJECTIVES

We aim to describe characteristics, assessments and outcomes of pregnant trauma patients (PTP) in South Australia (SA).

METHODS

The SA Trauma Registry was utilised to identify PTP from 1 July 2018-30 June 2023. Registry data and patient electronic medical records were analysed using descriptive statistics.

RESULTS

Four hundred two patients were included. The mean maternal and gestational ages were 28 years and 27 weeks, respectively. 80% had no comorbidities. Blunt trauma accounted for 98% of injury type. The mechanism of injury for 60% of patients was Motor Vehicle Crash; 16% were uninjured; 58% sustained minor soft tissue injuries only. Despite the low mean ISS (1.6, SD 2.87), trauma teams were activated in 95% of cases. A primary survey was documented in 34%. An obstetric clinician was documented as present in 4% of cases. 96% did not require a medical procedure; three patients underwent emergency Lower Segment Caesarean Section. 93% were discharged directly from ED. Admitted patients had a mean hospital LOS of 21.8 h. There were no maternal deaths. Two patients suffered trauma-related intrauterine foetal demise. The mean gestational age at delivery was 38 weeks; 12% had preterm delivery. No trauma-related neonatal deaths were recorded.

CONCLUSIONS

PTP presentations in SA are infrequent, primarily resulting in minor injuries. Trauma assessments are incompletely documented, and along with investigations, often do not adhere to local guidelines. Good trauma care for PTPs should involve an obstetrician and follow ATLS principles. Guidelines should be implemented and followed to ensure standardised comprehensive care of PTPs.