Annales françaises de médecine d'urgence

, Volume 6, Issue 5, pp 307–312 | Cite as

Complications obstétricales des traumatismes de la femme enceinte : épidémiologie dans une maternité d’un CHU en France

  • V. Richard-Jourjon
  • E. Dehours
  • M. Parant
  • O. Parant
  • M. Marchetti
  • D. Lauque
Article Original / Original Article

Résumé

Introduction

Les traumatismes de la femme enceinte sont fréquemment la cause de décès maternel et foetal non obstétrical ainsi que de complications maternofoetales durant la grossesse. L’objectif de notre étude était de décrire la population des femmes enceintes consultant pour un traumatisme dans un service d’urgences gynécoobstétricales et de rechercher les critères prédictifs d’hospitalisation et de complications obstétricales.

Méthodes

Étude rétrospective, basée sur l’analyse des dossiers médicaux des femmes enceintes admises aux urgences pour un traumatisme, entre le 1er janvier 2007 et le 31 décembre 2010. Les circonstances et les localisations des traumatismes, leurs complications obstétricales et leur prise en charge ont été étudiées.

Résultats

Parmi les 144 femmes étudiées, les traumatismes étaient dus à des chutes (45 %), des accidents de la voie publique (32 %) ou des violences conjugales (16 %). L’âge gestationnel moyen était de 29 semaines d’aménorrhée (SA). Leur localisation était abdominale dans 72 % des cas. Soixante-deux patientes (43 %) étaient hospitalisées dans les suites immédiates du traumatisme pendant une durée médiane de 2,5 jours. L’hospitalisation était plus fréquente lorsque le traumatisme était abdominal, l’âge gestationnel avancé (3e trimestre), qu’il existait des facteurs de risque antérieurs de grossesse compliquée ou que les examens réalisés en urgence étaient anormaux. L’âge gestationnel médian à l’accouchement était de 39 SA. Les complications obstétricales survenaient chez 25 patientes et comprenaient 18 ruptures prématurées des membranes, 3 hématomes rétroplacentaires, 2 ruptures utérines, 2 morts foetales et 17 accouchements prématurés.

Conclusion

Les traumatismes durant la grossesse, même mineurs, sont un facteur de morbidité et de mortalité foetale. Il est important de faire un bilan obstétrical complet devant tout traumatisme. Les patientes sont souvent hospitalisées par la suite, d’autant plus que le traumatisme est abdominal, que la grossesse est avancée ou qu’il existe des facteurs de risque de grossesse compliquée.

Mots clés

Grossesse Traumatisme Urgences Prématurité Complications 

Obstetrical complications of pregnancy trauma in the emergency department of a maternity hospital

Abstract

Introduction

Pregnant women injuries are the leading cause of maternal and fetal deaths and non-obstetric fetal complications during pregnancy. Aim of our study was to describe the population of pregnant women accessing trauma in gynecology and obstetrics emergencies and to search criteria of hospitalization and obstetric complications.

Methods

Retrospective study. Hospital records of pregnant women who came to the emergency trauma between January 1st, 2007 and December 31st, 2010 were analyzed to study circumstances and locations of trauma, obstetric complications and their management.

Results

Among the 144 women studied, injuries were due to falls (45 %), accidents of public roads (32 %) and domestic violences (16 %). The mean gestational age was 29 weeks of amenorrhea (WA). Location was abdominal in 72 % of cases. Sixty-two patients (43 %) were hospitalized in the immediate aftermath of trauma for a median of 2.5 days. Hospitalization was more common when abdominal trauma was the gestational age (3rd quarter), there were previous risk factors for complicated pregnancy or the emergency examinations were abnormal. Median gestational age at delivery was 39 WA. Obstetric complications occurred in 25 patients and included 18 premature ruptures of membranes, 3 placental hematoma, 2 uterine ruptures, 2 fetal deaths and 17 premature births.

Conclusion

Injuries during pregnancy, even minor, are a factor of morbidity and fetal mortality. It is important to make a full report to obstetrical trauma. Patients are often hospitalized later, especially if abdominal trauma is occurring during advanced pregnancy or with risk factors complicating pregnancy.

Keywords

Pregnancy Trauma Emergency Prematurity Complication 

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Copyright information

© Société française de médecine d'urgence and Springer-Verlag France 2016

Authors and Affiliations

  • V. Richard-Jourjon
    • 1
  • E. Dehours
    • 2
  • M. Parant
    • 2
  • O. Parant
    • 3
    • 4
  • M. Marchetti
    • 1
  • D. Lauque
    • 2
    • 4
  1. 1.Pôle de médecine d’urgenceCHU de PoitiersPoitiersFrance
  2. 2.Pôle de médecine d’urgenceCHU de Toulouse, hôpital PurpanToulouseFrance
  3. 3.Pôle de gynécologie-obstétriqueCHU de Toulouse, hôpital PurpanToulouseFrance
  4. 4.Université Paul Sabatier, Toulouse IIIToulouse cedex 09France

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