Forensic Medical Evaluation of Pregnant Cases: An Analysis of Trauma and Outcomes
DOI:
https://doi.org/10.17986/blm.1744Keywords:
Pregnancy, Partner violence, Assault, MiscarriageAbstract
Objective: Trauma during pregnancy poses significant risks to both the mother and the fetus. This study aims to retrospectively evaluate the forensic and medical aspects of cases involving pregnant individuals examined by forensic medicine.
Methods: A retrospective analysis was conducted on 6,082 forensic cases admitted to the Department of Forensic Medicine at Ordu University Training and Research Hospital between January 1, 2019, and December 31, 2023. Twenty-five cases identified as pregnant during the incident were included. Evaluations were based on age, incident origin, forensic examination, emergency and obstetric assessments, interval between evaluations, gestational age, and miscarriage status.
Results: The mean age of cases was 24 ± 5.89 years, and 72% were exposed to trauma from assault, with 83.3% linked to partner violence. Hyperemia (40%) was the most common traumatic sign, while extremities (40%) and the abdomen (35%) were the most frequently injured regions. The mean gestational age was 22.6 ± 8.10 weeks, with 64% showing no ultrasonographic pathologies. Retroplacental hematoma was the most common anomaly. Two cases (8%) required advanced treatment, including one miscarriage from anterior placental bleeding and one incomplete abortion due to firearm injury. A significant correlation was found between abdominal trauma and ultrasonographic findings (Phi = 0.55, p = 0.006).
Conclusion: The study reveals that most pregnancy-related trauma cases are due to assault, with a significant portion linked to partner violence. Timely and accurate forensic reporting is vital in domestic violence cases for ensuring accountability.
Downloads
References
Patterson J, Garcia J, Nguyen T. Pregnancy and trauma: Clinical implications and management. J Ma-tern Health. 2020;15(2):129-138. https://doi.org/10.1016/j.mhj.2020.02.129
Shatalova Y, Zakupova T, Galitskiy F, Gülmen MK, Kaya K, Yavuz TK. Analysis of the pregnancy out-come in severe injury in pregnant women according to forensic examinations for 2008-2017 in Asta-na. Bull Leg Med. 2023;28(1):23-31. https://doi.org/10.17986/blm.1620
Smid M, Ohana J, Zephyrin L. Trauma-induced pregnancy outcomes. Obstet Gynecol J. 2019;114(3):300-310. https://doi.org/10.1016/j.ogj.2019.06.300
Fabricant SP, Greiner KS, Caughey A. Association between trauma in pregnancy and adverse fetal and neonatal outcomes. Am J Obstet Gynecol. 2019;221(1):145-150. https://doi.org/10.1016/j.ajog.2018.11.502 DOI: https://doi.org/10.1016/j.ajog.2018.11.502
American College of Obstetricians and Gynecologists. Guidelines for obstetric trauma. ACOG Clin Rep. 2021. Available from: https://www.acog.org
Ergönen AT, Özdemir M, Can I, Sönmez E, Salaçin S, Berberoğlu E, Demir N. Domestic violence on pregnant women in Turkey. J Forensic Leg Med. 2009;16(3):125-129. https://doi.org/10.1016/j.jflm.2008.08.009 DOI: https://doi.org/10.1016/j.jflm.2008.08.009
Devries MK, Kishor S, Johnson H, et al. Intimate partner violence during pregnancy: Analysis of prevalence data from 19 countries. Reprod Health Matters. 2010;18(36):158-170. https://doi.org/10.1016/S0968-8080(10)36533-5 DOI: https://doi.org/10.1016/S0968-8080(10)36533-5
Kuo C, Jamieson DJ, McPheeters ML, et al. Injury hospitalizations of pregnant women in the United States. Am J Obstet Gynecol. 2007;196(4):1614-1620. https://doi.org/10.1016/j.ajog.2006.09.015 DOI: https://doi.org/10.1016/j.ajog.2006.09.015
Drexler KA, Quist-Nelson J, Weil AB. Intimate partner violence and trauma-informed care in preg-nancy. Am J Obstet Gynecol MFM. 2022;4(2):100542. https://doi.org/10.1016/j.ajogmf.2021.100542 DOI: https://doi.org/10.1016/j.ajogmf.2021.100542
Bo M, Canavese A, Magnano L, Rondana A, Castagna P, Gino S. Violence against pregnant women in the experience of the rape centre of Turin: Clinical and forensic evaluation. J Forensic Leg Med. 2020;76:102071. https://doi.org/10.1016/j.jflm.2020.102071 DOI: https://doi.org/10.1016/j.jflm.2020.102071
Koirala S. Intimate partner violence and adverse pregnancy outcomes. Kathmandu Univ Med J. 2022;20(3):289-293. https://doi.org/10.3126/kumj.v20i3.53933 DOI: https://doi.org/10.3126/kumj.v20i3.53933
Chisholm CA, Bullock L, Ferguson JE. Intimate partner violence and pregnancy: epidemiology and impact. Am J Obstet Gynecol. 2017;217(2):145-149. https://doi.org/10.1016/j.ajog.2017.05.042 DOI: https://doi.org/10.1016/j.ajog.2017.05.043
Fabricant SP, Greiner KS, Caughey AB. Trauma in pregnancy and severe adverse perinatal out-comes. J Matern Fetal Neonatal Med. 2021;34(18):3070-3074. https://doi.org/10.1080/14767058.2019.1678129 DOI: https://doi.org/10.1080/14767058.2019.1678129
Van Parys AS, Verhamme A, Temmerman M, Verstraelen H. Intimate partner violence and preg-nancy: A systematic review of interventions. PLoS One. 2014;9(1):e85084. https://doi.org/10.1371/journal.pone.0085084 DOI: https://doi.org/10.1371/journal.pone.0085084
Petrone P, Jiménez-Morillas P, Axelrad A, Marini CP. Traumatic injuries to the pregnant patient: A critical literature review. Eur J Trauma Emerg Surg. 2019;45(3):383-392. https://doi.org/10.1007/s00068-017-0839-x DOI: https://doi.org/10.1007/s00068-017-0839-x
Shatalova Y, Zakupova T, Galitskiy F, Gülmen MK, Kaya K, Yavuz TK. Analysis of the pregnancy out-come in severe injury in pregnant women according to forensic examinations for 2008-2017 in Asta-na. Bull Leg Med. 2023;28(1):41-46. https://doi.org/10.17986/blm.1620 DOI: https://doi.org/10.17986/blm.1620
Deshpande NA, Kucirka LM, Smith RN, Oxford CM. Pregnant trauma victims experience nearly 2-fold higher mortality compared to their nonpregnant counterparts. Am J Obstet Gynecol. 2017;217(5):590.e1. https://doi.org/10.1016/j.ajog.2017.08.004 DOI: https://doi.org/10.1016/j.ajog.2017.08.004
Alkis I, Karadas S, Karaman E, Gülşen I, Öncü R, Çim N, Dursun R. Maternal and fetal outcomes of 179 traumatised pregnants in a tertiary referral center. Open J Obstet Gynecol. 2014;4(16):1063-1070. https://doi.org/10.4236/ojog.2014.416142 DOI: https://doi.org/10.4236/ojog.2014.416142
Nannini A, Lazar J, Berg C, Barger M, Tomashek K, Cabral H, Kotelchuck M. Physical injuries reported on hospital visits for assault during the pregnancy-associated period. Nurs Res. 2008;57(3):144-149. https://doi.org/10.1097/01.nnr.0000319502.97864.0e DOI: https://doi.org/10.1097/01.NNR.0000319502.97864.0e
Oxford CM, Ludmir J. Trauma in pregnancy. Clin Obstet Gynecol. 2009;52(4):611-629. https://doi.org/10.1097/GRF.0b013e3181c11edf DOI: https://doi.org/10.1097/GRF.0b013e3181c11edf
Harland KK, Saftlas AF, Yankowitz J, Peek-Asa C. Risk factors for maternal injuries in a population-based sample of pregnant women. J Womens Health. 2014;23(12):1033-1038. https://doi.org/10.1089/jwh.2013.4560 DOI: https://doi.org/10.1089/jwh.2013.4560
Alsadery HA, Bamalan OA, Aljubran HJ, Albaish LJ, Al Ghanim BZ. Non-obstetric acute abdomen in pregnancy: A review of literature. Med Arch. 2023;77(4):293-298. https://doi.org/10.5455/medarh.2023.77.293-298 DOI: https://doi.org/10.5455/medarh.2023.77.293-298
Gezginç K, Göktepe H. Approach to trauma in pregnancy. Selcuk Univ Med J. 2011;27:250-254.
Kilpatrick SJ. Trauma in Pregnancy: An Underappreciated Cause of Maternal Death. Obstet Anesth Dig. 2018;38(3):127-128. https://doi.org/10.1016/j.ajog.2017.09.012 DOI: https://doi.org/10.1097/01.aoa.0000542345.82008.6c
Schiff MA, Holt VL, Daling JR. Maternal and infant outcomes after injury during pregnancy in Wash-ington State from 1989 to 1997. J Trauma Acute Care Surg. 2002;53(5):939-945.https://doi.org/10.1097/00005373-200211000-00021 DOI: https://doi.org/10.1097/00005373-200211000-00021
Chames MC, Pearlman MD. Trauma during pregnancy: outcomes and clinical management. Clin Ob-stet Gynecol. 2008;51(2):398-408. https://doi.org/10.1097/grf.0b013e31816f2aa7 DOI: https://doi.org/10.1097/GRF.0b013e31816f2aa7
El Kady D, Gilbert WM, Anderson J, Danielsen B, Towner D, Smith LH. Trauma during pregnancy: An analysis of maternal and fetal outcomes in a large population. Am J Obstet Gynecol. 2004;190(6):1661-1668. https://doi.org/10.1016/j.ajog.2004.02.051 DOI: https://doi.org/10.1016/j.ajog.2004.02.051
Downloads
Published
Versions
- 2025-04-19 (2)
- 2025-03-13 (1)
Issue
Section
License
Copyright (c) 2025 Halit Canberk Aydogan- Hacer Yaşar Teke- Hanım Gökçe Arslan

This work is licensed under a Creative Commons Attribution 4.0 International License.
The Journal and content of this website is licensed under the terms of the Creative Commons Attribution (CC BY) License. The Creative Commons Attribution License (CC BY) allows users to copy, distribute and transmit an article, adapt the article and make commercial use of the article. The CC BY license permits commercial and non-commercial re-use of an open access article, as long as the author is properly attributed.