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Original Article
- Use of the Obstetric Early Warning Score in emergency triage for pregnant trauma patients: a retrospective cross-sectional study on a tool for early hospitalization decision-making
- Figen Topalak, Selen Acehan, Salim Satar, Muge Gulen, Sarper Sevdimbas, Kadir Nigiz, Mehmet Gorur, Ali İsa Aslan, Ihsan Dengiz
- Received May 7, 2025 Accepted July 9, 2025 Published online December 29, 2025
- DOI: https://doi.org/10.20408/jti.2025.0104 [Epub ahead of print]
- 952 View
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Abstract
PDF - Purpose
Traumatic injuries during pregnancy present significant challenges for emergency providers, necessitating rapid assessment to ensure the safety of both mother and fetus. Scoring systems that can be applied immediately upon presentation may facilitate early triage and inform disposition decisions. This study evaluated the predictive performance of the Obstetric Early Warning Score (OEWS), Injury Severity Score (ISS), and Revised Trauma Score (RTS) in determining hospitalization needs among pregnant trauma patients admitted to the emergency department (ED).
Methods
This retrospective cross-sectional study included pregnant trauma patients aged 18 years or older who were admitted to a tertiary care ED between January 2019 and December 2022. Demographic, clinical, laboratory, and trauma-related data were collected. OEWS, ISS, and RTS were calculated at admission. The primary outcome was the requirement for hospitalization. Binary logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess predictive performance.
Results
A total of 316 pregnant trauma patients were included. Hospitalization was required in 14.9% of cases. Higher OEWS (mean, 2.63 vs. 0.33; P=0.001) and ISS (mean, 18.02 vs. 5.04; P<0.001) were significantly associated with hospitalization. In multivariate analysis, OEWS (odds ratio [OR], 1.553; 95% confidence interval [CI], 1.087–2.219; P=0.016) and ISS (OR, 1.170; 95% CI, 1.083–1.264; P<0.001) were independent predictors of hospitalization. ROC analysis demonstrated that ISS had the highest predictive value (area under the curve, 0.783; 95% CI, 0.695–0.870; P<0.001).
Conclusions
Both ISS and OEWS are effective tools for predicting hospitalization needs in pregnant trauma patients. Incorporating these scoring systems into ED triage protocols may enhance early identification of high-risk patients and improve outcomes for both mothers and fetuses. -
SummaryCase Report
- Treatment of placental abruption following blunt abdominal trauma: a case report
- Jinjoo Kim, Seokyung Kim, Dongwook Kwak, Donghwan Choi
- J Trauma Inj. 2025;38(1):61-65. Published online December 4, 2024
- DOI: https://doi.org/10.20408/jti.2024.0050
- 9,017 View
- 223 Download
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Abstract
PDF
- Trauma during pregnancy poses a potentially tragic risk to both the fetus and mother, making its management particularly challenging. Here, we present the case of a 35-year-old woman at 34 weeks and 2 days gestation who was in a motor vehicle accident and subsequently suffered placental abruption and underwent an emergency cesarean section. We also present a review of traumatic placental abruption and its epidemiology. On arrival at the trauma bay, the patient showed no significant abdominal findings other than a seat belt sign. However, 2 hours after admission, the patient developed abdominal pain and vaginal bleeding. Ultrasonography revealed no clear evidence of placental abruption. This case demonstrates the necessity of close maternal and fetal monitoring with cooperation between the trauma and obstetric teams. Even in the absence of typical symptoms such as abdominal pain on initial presentation, a high-energy mechanism of injury should be suspected.
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