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Maternal Medicine Posters
A retrospective audit on the management of trauma in pregnancy
  1. J Elliot,
  2. O Eniola
  1. Wexham Park Hospital, Slough, United Kingdom

Abstract

Background Trauma affects 7% of all pregnancies and requires admission in 4 out of 1000 pregnancies. This audit was conducted in order to review the management of abdominal trauma in pregnancy at Wexham Park Hospital, Slough.

Method A retrospective review of the management of abdominal trauma in pregnancy for a period of one year, between May 2008 and April 2009. This was undertaken using a proforma based on the trust guideline.

Results A total of 75 patients were admitted with abdominal trauma in pregnancy of which 48 case notes were available for review. Majority of patients (85%; 41/48) presented with history of fall, of which 75% (36/48) had no significant complications following such trauma. Only 11 of 48 cases reviewed had significant complications, of which abdominal pain was the commonest, occurring in 6/11 (55%). Most patients (40/48; 83%) had no documentation about inspection for bruising, kleihaur-betke's test was only performed in 33 % (16/48). 75% (36/48) were discharged home same day without meeting our minimum requirement of at least 4hours of continuous CTG.

Conclusion This audit demonstrated that majority of the patients admitted with trauma had no significant adverse outcome; however there was still a lack of consistency and standardisation in their management. We recommend that all pregnant women admitted with trauma have a kleihaur-betke's test and have at least a minimum of 4hours of continuous CTG as per guideline. This can be improved with perhaps a standardised proforma which could demonstrate a pictorial evidence of bruising and actions undertaken.

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