Guidelines for the Management of a Pregnant Trauma Patient
Guidelines for the Management of a Pregnant Trauma Patient
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DOI：
10.1016/s1701-2163(15)30232-2
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发表时间：
2015-06-01
影响因子：
1.8
通讯作者：
Sanderson, Frank
中科院分区：
文献类型：
--
作者：
Jain, Venu;Chari, Radha;Sanderson, Frank
目的：每12名孕妇中就有1名受到身体创伤，对孕产妇死亡率和发病率以及妊娠结局有重大影响。一个多学科的方法是必要的，以优化结果的母亲和她的胎儿。本文件的目的是提供产科护理提供者一个基于证据的系统的方法，以怀孕的创伤patient.Outcomes：显着的健康和经济后果的比较替代practices.Evidence：发表的文献检索通过检索Medline，CINAHL，和科克伦图书馆从2007年10月至2013年9月使用适当的控制词汇（例如，妊娠、剖腹产、低血压、家庭暴力、休克）和关键词（例如，结果仅限于1968年1月至2013年9月期间以英文发表的系统综述、随机对照试验/对照临床试验和观察性研究。定期更新这些信息，并将其纳入截至2014年2月的准则。灰色（未发表）的文献，确定通过搜索网站的卫生技术评估和卫生技术相关机构，临床实践指南的集合，临床试验登记处，和国家和国际医学专业society.Values：在这份文件中的证据的质量进行了评级使用的标准报告中描述的加拿大工作组预防保健（表1）。好处，危害，和成本：本指南预计将促进最佳和统一的护理怀孕并发traumatic.Summary声明具体的创伤injuriesAt这个时候，有足够的证据支持禁用安全气囊的做法孕妇。（三）初步调查建议1.每一个有重大损伤的育龄女性都应该被认为是怀孕了，直到通过明确的怀孕测试或超声波扫描证明。（III-C）[图表]
Objective: Physical trauma affects 1 in 12 pregnant women and has a major impact on maternal mortality and morbidity and on pregnancy outcome. A multidisciplinary approach is warranted to optimize outcome for both the mother and her fetus. The aim of this document is to provide the obstetric care provider with an evidence based systematic approach to the pregnant trauma patient.Outcomes: Significant health and economic outcomes considered in comparing alternative practices.Evidence: Published literature was retrieved through searches of Medline, CINAHL, and The Cochrane Library from October 2007 to September 2013 using appropriate controlled vocabulary (e.g., pregnancy, Cesarean section, hypotension, domestic violence, shock) and key words (e.g., trauma, perimortem Cesarean, Kleihauer-Betke, supine hypotension, electrical shock).Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies published in English between January 1968 and September 2013. Searches were updated on a regular basis and incorporated in the guideline to February 2014. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies.Values: The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table 1). Benefits, harms, and costs: This guideline is expected to facilitate optimal and uniform care for pregnancies complicated by trauma.SUMMARY STATEMENTSpecific traumatic injuriesAt this time, there is insufficient evidence to support the practice of disabling air bags for pregnant women. (III)RECOMMENDATIONSPrimary survey 1. Every female of reproductive age with significant injuries should be considered pregnant until proven otherwise by a definitive pregnancy test or ultrasound scan. (III-C)[GRAPHICS]