Introducere: Traumatismul in timpul sarcinii, in 46% este principala cauza de deces, decesul fatului in leziunile severe este de 61% - 80%, determinand imbunatatirea conduitei gravidelor cu traumatism. Scopul: Analiza conduitei gravidelor cu traumatismul centurii pelviene. Material si metode: Studiu 5 femeilor gravide cu traumatismul centurii pelviene. Varsta medie 24?6,04ani. Cauzele traumatismului: accidente rutiere n=2, caderea n=1, ruptura simfizei n=2. Investigatiile: examenul clinic; ginecologic; USG; radiografia, etc. Valoarea medie a severitatii leziunilor: Glasgow=13,8?1,78; ISS=17,95?13,73 puncte. Tratamentul efectuat a fost complex si individual. Studiul finantat Agentiei N Cercetare D, proiectul nr.20.80009.8007.11, 20.800009.8007. Rezultate: Structura traumatismului: fractura bazinului – tip A, leziunea simfizei- n=2, tip C- n=1; fractura osului sacral (n=1), femurului (n=2); leziunea vezicii urinare (n=1). La gravide (n=2) cu leziunea simfizului, conduita conservativa. Osteosinteza simfizei cu placa a fost efectuata dupa nastere. Graviditatea traumatismului pacientei cu fractura bazinului tip C ISS=41 puncte. Masuri de urgenta: cezariana, resuscitare, stabilizarea oaselor bazinului si femurului cu dispozitive externe. La o pacienta (S1, N0, G27 saptamani) cu fractura femurului la a 4 zi efectuata osteosinteza coapsei. Sarcina pastrata. Concluzii: Managementul femeii insarcinate post-traumatice este indreptat la tratarea a doua victime - mama si fatul. Gravitatea leziunilor traumatice ale mamei determina rezultatul probabil al ambelor: toate masurile terapeutice sunt indreptate in primul rand spre mama si apoi - fatul. Conduita gravidelor cu fracturile centurii pelviene consta in diagnosticul precis, rapid a leziunilor interne, fracturile aparatului locomotor, starii generale a fatului cu efectuarea operatiilor urgente de reanimare, minim traumatice. Conduita diagnostico-curativa posttraumatica a gravidelor este intotdeauna individuala.

Introduction: Trauma during pregnancy is the main cause of death in 46%, fetal death in severe injuries is 61% - 80%. Aim: Management analysis of pregnant women with pelvic girdle trauma. Material and methods: Study included 5 pregnant women with pelvic girdle trauma. Age 24?6,04 years. Causes of trauma: road accidents n=2, fall n=1, symphysis rupture n=2. Investigations: gynecological, USG; radiography, etc. Mean value of the severity lesions: Glasgow=13,8?1,78; ISS=17,95?13,73. Treatment was complex, individual. Study funded by NResearchDAgency, project no.20.80009.8007.11, 20.800009.8007. Results: Trauma structure: pelvic fracture- type A, symphysis lesion- n=2, type C - n=1; fracture of the sacrum (n=1), femur (n=2); urinary bladder injury (n=1). Initially pregnant (n=2) with symphysis lesion were treated conservatively. Later symphysis osteosynthesis was performed by plate after birth. Severity of trauma of patient with pelvic fracture type C ISS=41 points. Emergency performed: cesarean; resuscitation measures; pelvic, femoral bones stabilization with external device. Osteosynthesis of the femur was performed in one patient (S1, N0, G27 weeks) on the 4th day. Pregnancy was preserved. Conclusions: Management of post-traumatic pregnant woman is aimed at treating two victims - mother and fetus. Severity of the traumatic injuries of the mother determines the probable result of both: all therapeutic measures are directed firstly to the mother and secondly to the fetus. Conduct of pregnant women with pelvic girdle lesions consists of rapid diagnosis of internal injuries, bone fractures, the general condition of the fetus with urgent resuscitation operations, minimally traumatic. The diagnostic-curative conduct of post-traumatic pregnant women is always individual.