Pregnant women injured in terror-related multiple casualty incidents: Injuries and outcomes

OBJECTIVE: To characterize the injuries incurred by involvement in terror-related multiple casualty incidents (TR-MCIs) during pregnancy and describe the maternal and fetal outcomes. METHODS: Retrospective (January 1, 2001-December 31, 2003), descriptive, multicenter study of all pregnant women injured in TR-MCIs. RESULTS: Twelve pregnant women (singletons, gestational age 20.6 ± 10.5 weeks) who were injured during the study period. One victim was intubated on location of the event, another was hemodynamically compromised upon arrival. All women survived. Seven women required surgical intervention with general anesthesia. Four of the five women with viable pregnancies required cesarean delivery within minutes to hours of arrival. Three of these fetuses were delivered in extremis and one died. CONCLUSIONS: Women with a viable pregnancy who have been injured in TR-MCIs have a high incidence of surgical procedures and a high likelihood of undergoing cesarean delivery within minutes to hours of injury. Fetal outcome may be poor under these circumstances.