Introducere: Traumatismul asociat al gravidelor se caracterizeaza prin sindromul de agravare reciproca a leziunilor, ce provoaca dezvoltarea complicatiilor, „triada letala”: coogulopatie, hipotermie, acidoza pe fondal pierderii traumatice de sange, care duce la cresterea mortalitatii materne (46%), perinata (61-80%) si determina relevanta cercetarilor ulterioare. Scopul: Analiza particularitatilor gravidelor cu traumatismul asociat. Material si metode: Studiu a 12 gravide cu traumatism asociat. Varsta 27?7,04ani. Cauzele traumatismului: accidente rutiere 8(66,66%), cadere 2(16,66%), agresiune fizica 2(16,66%). În I trimestru de sarcina- 3(25%), II- 5(41,66%), III-4(33,33%). Valoarea medie a severitatii leziunilor: Glasgow=13,8?1,78; ISS=17,95?13,73 puncte. Traume asociate: fractura bazinului tip C-1, fracturi extrimitatilor-16, traumatismul închis al abdomenului - contuzie a peretelui abdominal anterior-12, leziunea vezicii urinare-1, placenta previa-7, hemoragii intrauterine-2, etc. Investigatiile si tratamentul au fost complexe si individuale. Studiul finantat ANCD, proiectul nr. 20.80009.8007.07, 20.800009.8007.11. Rezultate: Efectuat de urgenta: masuri de resuscitare, cezariana (n=3), înlaturarea uterului (n=1). Fracturile s-au tratat prin osteosinteza miniinvaziva cu dispozitiv de fixare externa. Radiografia de control a bazinului a confirmat consolidarea, eficacitatea tratamentului. La 3 paciente radiologic diagnosticata osteoporoza tranzitorie. În lotul studiului preponderent predomina fracturile scheletului. La o pacienta cu trauma asociata grava s-a dezvoltat „triada letala”, pacienta a decedat. La pacienta cu fractura bazinului tip C deces la fat. La 9 gravide sarcina a fost pastrata. Concluzii: Gravidele traumatizate sunt paciente speciale, prin urmare, în timpul terapiei intensive, toate masurile necesita sa vizeze eliminarea „triadei letale”, implementarea procedurilor si interventiilor mini traumatice, fiind baza pentru îmbunatatirea rezultatelor tratamentului.

Introduction: Associated trauma in pregnant women is characterized by the syndrome of reciproc aggravation of injuries, complications and the ""lethal triad"": coagulopathy, hypothermia, acidosis among the traumatic blood loss, which leads to increased maternal (46%), perinatal (61 -80%) mortality. Aim: Analysis of the particularity of pregnant women with associated trauma. Material and methods: Study of 12 pregnant women with associated trauma. The average age 27?7,04years. Causes of trauma: road accidents-8(66,66%), falling-2(16,66%), physical aggression-2(16,66%); I trimester of pregnancy-3 (21,42%), II-5 (%), III-4 (28,57)%. The mean value of Glasgow score=13,8?1,78; ISS=17,95?13,73 points. Associated trauma: fracture of the pelvis-1, upper and lower extremities -16, closed abdominal trauma - contusion of the anterior abdominal wall-12, bladder injury-1, placenta previa-7, intrauterine hemorrhage-2, etc. The investigations and treatment were complex and individual. Study funded by the ResearchAgencyD, project no.20.80009.8007.07, 20.800009.8007.11. Results: Urgent operations: resuscitation measures, cesarean section (n=3), removal of the uterus (n=1). Fractures were treated by minimally invasive osteosynthesis with external device. The control radiograph of the pelvis confirmed the consolidation, the effectiveness of the treatment. Transient osteoporosis was radiologically diagnosed in 3 patients. In the study group, skeletal fractures predominate. A ""lethal triad"" developed in a patient with severe associated trauma, the patient died. In the patient with pelvic fracture type C-death of the fetus. The pregnancy was maintained in 9 cases. Conclusions: Traumatized pregnant women are special patients. Therefore, during intensive care, all measures should be aimed at eliminating the ""lethal triad"", implementing minimally traumatic procedures and interventions to improve the treatment results.