Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study
Abstract Background Fetal radiation exposure in pregnant women with trauma is a concern. The purpose of this study was to evaluate fetal radiation exposure with regard to the type of injury assessment performed. Methods It is a multicentre observational study. The cohort study included all pregnant...
| Main Authors: | , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13049-023-01084-y |
| _version_ | 1797831957882601472 |
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| author | Paer-Selim Abback Alison Benchetrit Nathalie Delhaye Jean-Luc Daire Arthur James Arthur Neuschwander Mathieu Boutonnet Fabrice Cook Hélène Vinour Jean-Luc Hanouz Jean Cotte Bruno Pastene Viridiana Jouffroy Tobias Gauss Traumabase Group |
| author_facet | Paer-Selim Abback Alison Benchetrit Nathalie Delhaye Jean-Luc Daire Arthur James Arthur Neuschwander Mathieu Boutonnet Fabrice Cook Hélène Vinour Jean-Luc Hanouz Jean Cotte Bruno Pastene Viridiana Jouffroy Tobias Gauss Traumabase Group |
| author_sort | Paer-Selim Abback |
| collection | DOAJ |
| description | Abstract Background Fetal radiation exposure in pregnant women with trauma is a concern. The purpose of this study was to evaluate fetal radiation exposure with regard to the type of injury assessment performed. Methods It is a multicentre observational study. The cohort study included all pregnant women suspected of severe traumatic injury in the participating centres of a national trauma research network. The primary outcome was the cumulative radiation dose (mGy) received by the fetus with respect to the type of injury assessment initiated by the physician in charge of the pregnant patient. Secondary outcomes were maternal and fetal morbi-mortality, the incidence of haemorrhagic shock and the physicians’ imaging assessment with consideration of their medical specialty. Results Fifty-four pregnant women were admitted for potential major trauma between September 2011 and December 2019 in the 21 participating centres. The median gestational age was 22 weeks [12–30]. 78% of women (n = 42) underwent WBCT. The remaining patients underwent radiographs, ultrasound or selective CT scans based on clinical examination. The median fetal radiation doses were 38 mGy [23–63] and 0 mGy [0–1]. Maternal mortality (6%) was lower than fetal mortality (17%). Two women (out of 3 maternal deaths) and 7 fetuses (out of 9 fetal deaths) died within the first 24 h following trauma. Conclusions Immediate WBCT for initial injury assessment in pregnant women with trauma was associated with a fetal radiation dose below the 100 mGy threshold. Among the selected population with either a stable status with a moderate and nonthreatening injury pattern or isolated penetrating trauma, a selective strategy seemed safe in experienced centres. |
| first_indexed | 2024-04-09T14:00:01Z |
| format | Article |
| id | doaj.art-6d30549360ba41aa9de185599476cca7 |
| institution | Directory Open Access Journal |
| issn | 1757-7241 |
| language | English |
| last_indexed | 2024-04-09T14:00:01Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine |
| spelling | doaj.art-6d30549360ba41aa9de185599476cca72023-05-07T11:22:05ZengBMCScandinavian Journal of Trauma, Resuscitation and Emergency Medicine1757-72412023-05-013111810.1186/s13049-023-01084-yMultiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational studyPaer-Selim Abback0Alison Benchetrit1Nathalie Delhaye2Jean-Luc Daire3Arthur James4Arthur Neuschwander5Mathieu Boutonnet6Fabrice Cook7Hélène Vinour8Jean-Luc Hanouz9Jean Cotte10Bruno Pastene11Viridiana Jouffroy12Tobias Gauss13Traumabase Group14Department of Anesthesiology and Intensive Care, AP-HP.Nord, Beaujon Hospital, DMU PARABOLDepartment of Anesthesiology, Burn and Critical Care, Saint-Louis-Lariboisiere University Hospital, APHPDepartment of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, AP-HPRadiology department, AP-HP.Nord, Beaujon HospitalDMU DREAM, Department of Anesthesiology and critical care, Sorbonne University, AP-HP, Pitié-Salpêtrière HospitalDepartment of Anesthesiology and Critical Care Medicine, Hôpital Européen Georges Pompidou, AP-HPDepartment of Anesthesiology and Intensive Care, Percy Military Teaching HospitalService d’Anesthésie et des Réanimations chirurgicales, Hôpitaux Universitaires Henri Mondor, Assistance Publique - Hôpitaux de Paris (APHP)Department of Anesthesiology and Critical Care, Toulouse University Hospital, UniversityDepartment of Anesthesiology and Intensive Care, University Hospital of CaenIntensive Care Unit, HIA Sainte Anne, Military Teaching HospitalDepartment of Anesthesiology and Critical Care, Nord Hospital, Assistance Publique Hôpitaux Universitaires de Marseille, Aix Marseille UniversitéDepartment of Anesthesiology and Intensive Care, AP-HP, Kremlin-Bicêtre HospitalDepartment of Anesthesiology and Intensive Care, AP-HP.Nord, Beaujon Hospital, DMU PARABOLDepartment of Anesthesiology and Intensive Care, AP-HP.Nord, Beaujon Hospital, DMU PARABOLAbstract Background Fetal radiation exposure in pregnant women with trauma is a concern. The purpose of this study was to evaluate fetal radiation exposure with regard to the type of injury assessment performed. Methods It is a multicentre observational study. The cohort study included all pregnant women suspected of severe traumatic injury in the participating centres of a national trauma research network. The primary outcome was the cumulative radiation dose (mGy) received by the fetus with respect to the type of injury assessment initiated by the physician in charge of the pregnant patient. Secondary outcomes were maternal and fetal morbi-mortality, the incidence of haemorrhagic shock and the physicians’ imaging assessment with consideration of their medical specialty. Results Fifty-four pregnant women were admitted for potential major trauma between September 2011 and December 2019 in the 21 participating centres. The median gestational age was 22 weeks [12–30]. 78% of women (n = 42) underwent WBCT. The remaining patients underwent radiographs, ultrasound or selective CT scans based on clinical examination. The median fetal radiation doses were 38 mGy [23–63] and 0 mGy [0–1]. Maternal mortality (6%) was lower than fetal mortality (17%). Two women (out of 3 maternal deaths) and 7 fetuses (out of 9 fetal deaths) died within the first 24 h following trauma. Conclusions Immediate WBCT for initial injury assessment in pregnant women with trauma was associated with a fetal radiation dose below the 100 mGy threshold. Among the selected population with either a stable status with a moderate and nonthreatening injury pattern or isolated penetrating trauma, a selective strategy seemed safe in experienced centres.https://doi.org/10.1186/s13049-023-01084-ySevere traumaPregnancyInitial assessment after injuryWhole-body computed tomography |
| spellingShingle | Paer-Selim Abback Alison Benchetrit Nathalie Delhaye Jean-Luc Daire Arthur James Arthur Neuschwander Mathieu Boutonnet Fabrice Cook Hélène Vinour Jean-Luc Hanouz Jean Cotte Bruno Pastene Viridiana Jouffroy Tobias Gauss Traumabase Group Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine Severe trauma Pregnancy Initial assessment after injury Whole-body computed tomography |
| title | Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study |
| title_full | Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study |
| title_fullStr | Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study |
| title_full_unstemmed | Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study |
| title_short | Multiple trauma in pregnant women: injury assessment, fetal radiation exposure and mortality. A multicentre observational study |
| title_sort | multiple trauma in pregnant women injury assessment fetal radiation exposure and mortality a multicentre observational study |
| topic | Severe trauma Pregnancy Initial assessment after injury Whole-body computed tomography |
| url | https://doi.org/10.1186/s13049-023-01084-y |
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