European Journal of Trauma and Emergency Surgery

, Volume 40, Issue 5, pp 561–566 | Cite as

Adherence to protocol in pregnant trauma patients? A 12-year retrospective study

Original Article



We investigated whether the standard (ATLS) trauma protocol was adhered to in cases of suspected multi-traumatized pregnant patients and if serious injuries were overlooked. We hypothesized that radiographic studies would be less frequent in pregnant trauma patients.


Forty-eight pregnant trauma patients were received in the observational period from January 2000 until May 2012; median age 30 years (range 16–40) and median stage of pregnancy 22 weeks (range 4–40). A retrospective review of patient files was performed.


Twenty-one percent of the pregnant trauma patients received a full trauma CT (T-CT) scan (head to pelvis), which was significantly lower than the percentage (62 %) of all primarily referred trauma patients in the same period. In the last four years of observation, the use of radiographic studies among pregnant trauma patients increased considerably. Along with this increase in the tendency to use T-CT over time during the observational period, there was also a rise in the median ISS. In addition, radiographic studies of the pelvis and abdominal area were performed only half as frequently as studies of the neck and chest.


Adherence to the ATLS protocol in pregnant trauma patients was low in relation to radiographic studies but, in spite of this, no known significant injuries were missed. We found that a pelvic fracture seems to be predictive of a high risk of obstetric complications, such as intrauterine death or the need for cesarean section, but we were not able to relate trauma in general to a higher risk of cesarean section or premature birth.


Trauma Trauma in pregnancy Pelvic fracture in pregnancy ATLS Radiation in pregnancy 



The authors would like to thank Jacob Steinmetz, Department of Anesthesiology and Trauma Center, Rigshospitalet, Copenhagen University Hospital, Denmark, and Michael Mørk Petersen, Department of Orthopedic Surgery, Rigshospitalet, Copenhagen University Hospital, Denmark.

Conflict of interest

P. Horstmann, C. F. Larsen and H. Grønborg declare that there is no actual or potential conflict of interest in relation to this article.

Compliance with Ethics Guidelines

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  1. 1.Department of Orthopedic Surgery and Trauma CenterRigshospitalet, Copenhagen University HospitalCopenhagenDenmark

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