Comprehensive Management of Pelvic Trauma in Pregnant Patients
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Abstract
Pelvic fractures occur frequently due to traffic accidents and high-energy. Pregnant women are susceptible to trauma, with one in 12 pregnancies complicated by such incidents, making trauma the leading cause of non-obstetric maternal deaths during pregnancy. Pelvic fractures during pregnancy pose significant risks, potentially leading to adverse pregnancy outcomes such as preterm delivery, placental abruption, fetal distress, and even maternal or fetal death. The physiological changes that occur during pregnancy, including increased blood volume and altered cardiovascular dynamics, further complicate the management of pelvic trauma in pregnant patients. Prompt and appropriate management of pelvic trauma in pregnant patients is essential to optimize outcomes for both the mother and the fetus. Initial evaluation and stabilization of the mother take precedence, with close attention to airway, breathing, and circulation. Diagnostic imaging, including pelvic X-rays and, when feasible, body CT or MRI, aids in assessing the extent of pelvic injury and identifying associated injuries. Definitive treatment of pelvic fractures may involve a combination of surgical fixation, bed rest, traction, and pelvic slings, depending on the severity of the injury. The timing and approach to delivery in pregnant patients with pelvic fractures require careful consideration, with vaginal delivery being a viable option in many cases, provided that the pelvic architecture remains intact.
Conclussions: The management of pelvic trauma in pregnant patients requires a multidisciplinary approach and careful consideration of maternal and fetal well-being. Further research is needed to establish clear treatment guidelines and preventive strategies to reduce the incidence of pelvic fractures during pregnancy and improve outcomes for both mother and fetus.
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