Trauma during pregnancy in a Nigerian setting: Patterns of presentation and pregnancy outcome

Trauma is an important health concern during pregnancy in developing nations though it is under-reported. The aim of this study was to determine the patterns of presentation and feto- maternal outcomes of trauma during pregnancy in a Nigerian setting. A hospital-based retrospective analysis of database of entire patient population who presented in Ebonyi State University Teaching Hospital, Abakaliki, with trauma during pregnancy. The data on demographics, obstetrics, and injury characteristic in addition to the outcome of all injured pregnant women hospitalized from January 2002 to December 2010 were analyzed. SPSS version 16 and quantitative skills software SISA were used in data analysis. Trauma-necessitated hospitalization in 12 per 1000 pregnant women admitted in antenatal ward and was a complication of pregnancy in 4.7 per 1000 live birth in the hospital. Physical assault was the predominant causative factor and accounted for 46% of injuries whereas road traffic accident (motorcycle injury related in over 80%) was involved in 30.2% of the patients. The parity of the patients was significantly related to the trimester of pregnancy at the time of injury - 73% of grand-multiparae and about 60% of primigravida involved presented with injury in the 3(rd) and 2(nd) trimester, respectively (P < 0.017). Preterm delivery (7.9%), abruptio placentae (4.8%), and stillbirth (4.8%) were common obstetric complications observed. Maternal mortality of 1.6% and fetal loss of 7.9% were associated with trauma. Injury prevention measures during pregnancy deserve a place in any policy response aimed at reducing feto-maternal morbidity and mortality in developing countries.