III. SLOVAK SURGICAL CONGRESSXXXIII. JOINT CONGRESS OF SLOVAK AND CZECH

SURGEONSXXX. REIMAN’S DAYS

SEPTEMBER 11 - 13, 2002

PREGNANT WOMEN IN CAR

HAVE WE GOT PROTECTION AGAINST ABDOMINAL TRAUMA ?

G. Ács, A. Furka*, T. Lesznyák I. Mikó, Gy.Pekár**, I. Furka, Department of Operative Techniques and Surgical Research

*2nd Department of Surgery, **Pathology

Medical and Health Science Center, Faculty of Medicine, University of Debrecen

www.surg.res.dote.hu e -mail: gacs@jaguar.dote.hu 

By the cause of death statistics the most of the deaths can be lead back to external effect in the age-group 15-49. In this category the motor vehicle accidents has got leading position.

The most of the pregnant women belongs to this age group.

The pregnancy does not increase the danger, but despite of this, the motor vehicle accidents are the leading causes of death at pregnant women also.

PREGNANCY

6-7% INJURY

50% MVC

1-3% FETAL DEATH

FATAL OUTCOME

MOTOR VECHICLE CRASHES

WITHOUT

AIR BAG

WITH

AIR BAG

WITHOUT

SEAT BELT

100 % 87 %

WITH

SEAT BELT

55 % 50 %

PREGNANCY

PREVENTION

INJURY

THE CAUSES OF FETAL LOSS

MATERNAL DEATHSEVERE INJURY OF THE MOTHERABDOMINAL INJURYHEMORRHAGIC SHOCKHYPOXIAUTERO-PLACENTAL DAMAGEFETAL INJURY

In case of a pregnant woman’s accident, injury the smallest trauma can endanger the pregnancy, direct fetal injuries can develop. The mother’s severe injury with or without fetal injuries leads to fetal damage or death.

If the mother die in the accident the fetus can survive it only in exceptional case, only if the conditions of the postmortem Cesarean section are given, may be at the scene.

In Hungary in 1998 from 181543 pregnancy 84242 ended by induced abortion, 15271 was the early and late fetal loss. If we project the data of the age group for the pregnant probably the vehicle accidents are responsible for 11 pregnant women’s death. If we see the previous data the trauma caused by motor vehicle can be responsible for 1-3% of the fetal loss, which means 150-500 died fetus per year.

For make the situation better, at the motor vehicle caused injuries, we have to look for chances first of all at the prevention. The choose of the motor vehicle’s type, the adequate road network and the adequate personal factor are the elements of the active security. At the personal factor it is necessary to stress the importance of the acquisition of the adequate knowledge, the good psychical and physical status.

Elements of the passive security’s inner part are the safety belt, headrest and the air bag. These safety devices are destined for decrease the severity of the trauma and the fetal and maternal mortality.

If the injury is happened the adequate special emergency supply and the first traumatology supply are determinant. In this view the chances of the injured patients are not the same in every place in Hungary. To build up the whole emergency and traumatology network takes years and it is very expensive.

26,2

25,5

26,9

24,5

25,0

25,5

26,0

26,5

27,0

WHOLE DATA DON'T DRIVES CAR CAR DRIVER

MEAN AGE

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'TDRIVES CAR

CAR DRIVER

EDUCATION LEVEL

GROUND MIDLE HIGH

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'T DRIVES CAR CAR DRIVER

SOCIALPOSITION

WRONG MIDLE GOOD

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'T DRIVES CAR CAR DRIVER

PREGNANCY

1 1-3 >3

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'T DRIVES CAR CAR DRIVER

GRAVIDITY AGE

1-3 MONTH 3-6MONTH MORE THAN 6 MONTH

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'T DRIVES CAR CAR DRIVER

OPINION ABOUT THE SEAT BELT

USEFUL

UNCERTAIN

HARMFUL

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'T DRIVES CAR CAR DRIVER

KNOWLEDGE ABOUT THE SEAT BELT USE

KNOW

PARTLY

DON'T KNOW

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

WHOLE DATA DON'T DRIVESCAR

CAR DRIVER

INFORMATION ABOUT THE SEAT BELT USE

HAVE INFORMATION

PARTLY

HAVEN'T INFORMATION

0

20

40

60

80

100

120

140

160

PE

RS

ON

WHOLE DATA DON'T DRIVESCAR

CAR DRIVERS

INFORMATION SOURCE

HAVEN'T INFORMATION

FROM TV, RADIO OR JOURNALS

FROM A NURSE

FROM OUR GENERAL PRACTICIONER

FROM GYNECOLOGY SPECIALIST

AT SPECIAL EDUCATION COURS

ANOTHER

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

BEFORE THE PREGNANCY DURING THE PREGNANCY

DRIVING HABITS

DON'T DRIVES CAR RARELY DRIVES

0

10

20

30

40

50

60

70

80

PE

RS

ON

BEFORE THEPREGNANCY

DURING THEPREGNANCY

SEAT BELT HABITS OF CAR DRIVERS

ALWAYS USESTHE SEAT BELT

RARELY USESTHE SEAT BELT

DON'T USES THE SEAT BELT

DON'T DRIVESCAR

By the data of the literature and by our investigations we think at the field of the prevention the adequate education and information are the most important and promptly realizable. The costs of this work would be recovered soon and the benefit would be measurable by the growing number of the fetal and maternal survivors.

Thank

you!