Uterine trauma in pregnancy after motor vehicle crashes with airbag deployment: A 30-case series

Background: We describe a cohort of women of at least 20 weeks gestation to determine the frequency of placental abruption or fetal compromise after a motor vehicle crash (MVC) with airbag deployment. Methods: A retrospective chart review was conducted at two urban emergency departments. All women of at least 20 weeks gestation with MVCs in which their airbag deployed and who were admitted for monitoring or trauma care between 1997 and 2002 were identified by the Trauma Registry for each hospital and included. Results: Thirty women in the 6-year period were identified. Gestational age (GA) at the time of the MVC ranged from 20 weeks to 37 weeks (median GA 29 weeks). Of the 30 women, 15 (50%) were belted drivers, 5 (17%) were unbelted drivers, 5 (17%) were belted front-seat passengers, and 5 (17%) were unbelted front-seat passengers. Median speed was 35 mph. One woman experienced placental abruption with subsequent intrauterine fetal demise. Twenty-two (73%, 95% CI: 58-89) experienced uterine contractions. Sixteen (53%, 95% CI: 36-71) reported abdominal pain. Abnormal fetal heart rate was documented in six patients (20%, 95% CI: 6-34). Vaginal bleeding was reported in two patients (7%). Only three women had no abnormal abdominal findings after the MVC. Conclusions: From this preliminary series, placental abruption does not appear to occur frequently in MVCs with airbag deployment. It is unclear if fetal risk is higher than that without airbags. A significant number of pregnant women do not wear seatbelts.