부산대학교 도서관

INTRODUCTION:: Traumatic events during pregnant are relatively common and remain a leading cause of non-obstetric maternal morbidity. Maternal physiologic changes generate alterations in maternal vital signs (VS). Utilizing maternal early warning criteria of VS (MEWS) may aid in identification and recognition of women with at risk of morbidity from traumatic injury. METHODS:: Retrospective cohort of pregnant women in Level I trauma center who presented with trauma from 2006-2017 by Emergency Medical Services (EMS). We compared Injury Severity Score (ISS) and TRISS in women with abnormal MEWS and normal MEWS VS from EMS records. Statistical tests included Fischer’s exact test for categorical variables and t test for comparisons of continuous variables. Linear regression models were used to evaluate predicting covariates correlation with ISS and TRISS. RESULTS:: Of the 460 pregnant women treated for trauma, 240 (52%) arrived by EMS and 56 (12%) women had at least one abnormal MEWs criteria on the scene and only 3 patients had more than 1 abnormal VS. Most common injury mechanism was MVC (75%), Assaults (9%) and falls (7%). ISS (8.3 vs 8.79, P=.45) and TRISS (0.993 vs 0.925, P=.14) were not significantly different between women with normal and abnormal MEWS. However, with multivariate linear regression, scene heart rate (P=.02, 95% CI 0.108 to 0.009) and respiratory rate (P=.013, 95% CI 0.3 to 0.03) significantly correlated with ISS. No scene maternal VS were associated with TRISS. CONCLUSION:: Although maternal vital signs correlate with injury severity, women with abnormal vitals utilizing MEWS criteria are not associated with more severe injury.