Orthopedic Trauma Tests OK in Pregnancy

A new study shows that x-ray examinations of the abdomen and other techniques used in orthopedic trauma diagnosis and stabilization pose little or no risk to pregnant women or the fetus, provided proper precautions are taken.

The extensive review of current data on orthopedic trauma and pregnancy, published in the March 2006 issue of the Journal of the American Academy of Orthopedic Surgeons (AAOS, Rosemont, IL, USA), additionally shows that stabilizing the mother quickly provides the optimal probability of a good outcome for the infant. Common diagnostic tests used in orthopedic trauma that do not pose serious risk to a fetus include standard x-rays, magnetic resonance imaging (MRI), ultrasound, and most computerized tomography (CT) scans. Emergency orthopedic surgery can also be safely performed on most pregnant patients.

However, anatomic and physiologic changes in pregnant women require special considerations. For example, a traumatic level of blood loss might not be immediately apparent, since arterial blood pressure often remains stable due to the increase in blood volume during pregnancy even if uterine blood flow is hindered. All radiographs should be performed in such a way as to minimize the amount of exposure to the fetus. Patients in later stages of pregnancy should not be placed flat on their backs--even for surgery—
because the weight of the uterus can compress the vena cava. Also, certain drugs that affect blood clotting are not recommended for most pregnant women.

Because orthopedic trauma is relatively common in pregnant women, it is critical for them to understand the importance of taking precautions, such as wearing seat belts, said Kyle R. Flik, M.D., an orthopedic surgeon at Northeast Orthopedics (Albany, NY, USA). But if a pregnant woman does suffer trauma, she can feel safe in knowing that initial tests performed to diagnose and stabilize her condition should not harm the fetus.

Among the recommendations of the study is that all females of childbearing age who are involved in a physically traumatic event should be required to take a pregnancy test as part of the standard emergency room evaluation.



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