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J Korean Soc Emerg Med > Volume 23(5); 2012 > Article
Journal of The Korean Society of Emergency Medicine 2012;23(5): 657-664.
The Characteristics of Injured Pregnant Patients Visiting Seven Emergency Departments
Woo Kook Yoo, Woo Jeong Kim, Juok Park, Chang Bae Park, Kyoung Jun Song, Yu Jin Kim, Seung Chul Lee, Jin Seong Cho, Seong Chun Kim, Kyung Hye Park
1Department of Emergency Medicine, Medical School of Jeju National University, Jeju, Korea.
2Biomedical Research Institute, Seoul National University Hospital, Seoul, Korea. juok.park@gmail.com
3Department of Emergency Medicine, Seoul National University College of Medicine, Seoul, Korea.
4Department of Emergency Medicine, Dongguk University Graduate School, Gyeongju, Korea.
5Department of Emergency Medicine, School of Medicine, Gachon University, Incheon, Korea.
6Department of Emergency Medicine, Gyeongsang National University Hospital, Jinju, Korea.
7Department of Emergency Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
In Korea, few studies have compared outcomes in injured pregnant women to their non-pregnant counterparts. The purpose of this study is to describe the characteristics of patients injured during pregnancy who visited seven emergency departments in South Korea.
The Korean Traumatic Brain and Spine Injury Research Network (KTBSIRN) database, based on 7(emergency department) from June, 2008 to September, 2010 was used to derive data on all injured patients between 12 and 49 years of age. Data were divided into two comparison groups: pregnant and non-pregnant women. For comparison of characteristics and admission by pregnancy, we selected patients using the statistical matching method according to hospital, age, and injury mechanism after comparison with all enrolled patients. Then, members of the pregnant women group were divided into two subgroups: <20 weeks and > or =20 weeks gestational age.
A total of 13,449 women were identified in a total of 76,596 injuries. Among them, 164(1.22%) women were pregnant. Fewer alcohol-related injuries were observed in pregnant women compared with non-pregnant women. Transportation was the leading mechanism of ED injury visits by pregnant women (52.4%). Emergency Medical Service (EMS) usage (22.0% vs. 14.6%, p<.0.008) and admission (14.0% vs. 7.9%, p<.0.001) were more common in pregnant women than in non-pregnant women. However, no significant difference was observed in injury severity scores. After matching, adjusted odds ratio of pregnancy for admission was 2.8(95% CI: 1.46~5.53). Less than half the number of pregnant women underwent an obstetric exam and non-stress test (NST) for the fetus (44.5% and 27.4%, respectively).
Injured pregnant women who visited the ED were used more medical resources but showed no significant difference in injury severity. Despite maternal and fetal risk after injury, obstetric exam including fetal monitoring was not performed appropriately. Therefore, establishment of standards for injured pregnant women is needed in many EDs.
Key words: Injury, Pregnancy, Emergency medical service
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