Placental Pathology After Low-Impact Maternal Trauma [ID: 1380074

Abstract

INTRODUCTION: Placental abruption is the most common cause of fetal death in cases of blunt trauma, and the majority of abruptions occur within 24 hours of the injury. Because of this potential complication, the observation time after trauma remains controversial. Our study aims to demonstrate the incidence of placental abruption and abnormal placental pathology at the time of delivery in women who have experienced low-impact trauma. METHODS: This was a retrospective cohort study of pregnant patients between the years of 2014 and 2020 at MedStar Washington Hospital Center who presented to triage for low-impact trauma identified by “trauma,” “IPV,” “fall,” or “MVA.” MedStar Health Research Institute IRB approved this study. Data from their evaluation during triage visit, mode of delivery, and placental pathology were assessed. Patients were de-identified and analyses included χ2 tests, linear regression, and multinomial logistic regression analyses, as appropriate (α=0.05). RESULTS: Of 184 patients identified, delivery data were available for 144 (79%). The mean time from trauma to delivery was 9 weeks. After delivery, the placental pathology was grossly assessed or sent to pathology, and 76.6% were intact with 7.6% noting an infarct when sent to pathology. Observation time did not predict placental infarction or calcification. The type of trauma did not correlate with mode of delivery (P=.629), prelabor preterm rupture of membranes (P=.746), placental infarct (P=.358), intact placenta (P=.834), or placental calcification (P=.288). CONCLUSION: Although a small percentage of patients who experienced low-impact trauma had infarction identified on placental pathology, no patients experienced clinical or pathologic placental abruption in 24 hours after trauma.