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Pregnancy and Trauma

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Trauma during pregnancy: an analysis of maternal and fetal outcomes in a large population.
El-Kady D, Gilbert WM, Anderson J, Danielsen B, Towner D, Smith LH.
Am J Obstet Gynecol. 2004 Jun;190(6):1661-8.

Rationale for inclusion: Women delivering during a trauma hospitalization had the worst outcomes, regardless of the severity of the injury. Women admitted during pregnancy (prenatal injury) had an increased risk of adverse outcomes at delivery, and therefore should be monitored closely during the subsequent course of the pregnancy. 

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Trauma and pregnancy.
Connolly AM, Katz VL, Bash KL, McMahon MJ, Hansen WF.
Am J Perinatol. 1997 Jul;14(6):331-6.

Rationale for inclusion: Prolonged monitoring was not helpful in management of pregnant trauma patients, we support the recommendation that initial external fetal monitoring be performed for 4 hr, and, if reassuring, the patient may be sent home with precautions. We also recommend an Rh-immunoglobulin work-up for all Rh-negative pregnant trauma patients, but do not recommend Kleihauer-Betke testing for Rh-positive women. 

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Abuse during pregnancy: effects on maternal complications and birth weight in adult and teenage women.
Parker B, McFarlane J, Soeken K.
Obstet Gynecol. 1994 Sep;84(3):323-8.

Rationale for inclusion: 1 in 5 teens and 1 in 6 women experienced abuse during pregnancy, which was related to low birth weight and late entry to prenatal care.  Points to the importance for screening for abuse during pregnancy.

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Assessing for abuse during pregnancy. Severity and frequency of injuries and associated entry into prenatal care.
McFarlane J, Parker B, Soeken K, Bullock L.
JAMA. 1992 Jun 17;267(23):3176-8.

Rationale for inclusion: A 3-question abuse assessment screen detected a 17% prevalence of abuse during pregnancy, and was frequently recurrent.

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A prospective controlled study of outcome after trauma during pregnancy.
Pearlman MD, Tintinallli JE, Lorenz RP.
Am J Obstet Gynecol. 1990 Jun;162(6):1502-7; discussion 1507-10.

Rationale for inclusion: 85 pregnant trauma patients compared with nontrauma, showing increased placental abruption. 4h of monitoring was sensitive to detect women who would have issues.

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