III. SLOVAK SURGICAL CONGRESS XXXIII. JOINT CONGRESS OF SLOVAK AND CZECH SURGEONS XXX. 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 *2 nd Department of Surgery, **Pathology Medical and Health Science Center, Faculty of Medicine, University of Debrecen www.surg.res.dote.hu e -mail: [email protected]
Transcript
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
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.
