Ruminations

Blog dedicated primarily to randomly selected news items; comments reflecting personal perceptions

Tuesday, May 13, 2014

Not Beware But Being Aware

"An effect of this magnitude equals about one crash for every fifty pregnant women."
"Motor vehicle crashes are the leading cause of fetal death related to maternal trauma."
"[Car crashes involving pregnant women] are enormously stressful for all the clinicians involved."
"The mom will usually survive because of the extra blood and the extra padding she has, but the downstream consequences for the fetus we just don't know, but it can't possibly be good for you."
"[If concussions are harmful in young children], they're also going to be a potential problem before you're born."
"We used to think that the surrounding amniotic fluid would be a perfect blanket for the fetus. It's just not true."
"Almost all of these collisions could be prevented by a small change in driver behaviour."
Dr. Donald Redelmeier, professor of medicine, University of Toronto, staff physician, Sunnybrook Health Sciences Centre

www.roaddriver.co.uk
Women Drivers - Driving Safety Tips for Pregnant Women. Tips and Advice - Article No.9 RoadDriver 2010
The conclusion that was arrived at through new research undertaken by Dr. Redelmeier and his team was that pregnancy and driving are not a good combination. And here we all thought that the use of alcohol and/or drugs during pregnancy was potentially harmful to the fetus, let alone its mother.

But no, there are concerns beyond the commonplace to be mindful of, and the study's conclusion and the work done by Dr. Redelmeier, a senior scientist at the Institute for Clinical Evaluative Sciences whose study conclusion was published in the Canadian Medical Association Journal, thus alerts the interested public.

The research team, working out of Sunnybrook Health Science Centre, in Toronto -- Canada's largest trauma unit, followed for a five-year-period; four years pre-delivery, one year post-delivery of every woman in Ontario giving birth between 2006 and 2011, whether emergency department visits relating to a car crash took place before, during or after pregnancy.

This was a study that involved examining a total of 507,262 women. For the three years pre-pregnancy women experienced 6,922 crashes at a rate of 177 monthly events. The second trimester indicated pregnant female drivers had 6,922 crashes at the rate of 252 per month representing a 42% increase in crash events over the previous pre-pregnancy years.

Surprisingly, it was during the last month of the third trimester that proved the least hazardous time for pregnant women to drive, when a crash rate of 2.4 events per one thousand individuals annually resulted. Pregnancy is the cause of physiological changes whose symptoms are well known to women; nausea, fatigue, insomnia; which are capable of increasing the risk of driver error.

Dr. Redelmeier spoke of some women complaining of "baby brain", representing momentary episodes of absent-mindedness. Emergency care and standard resuscitation techniques become more complicated during pregnancy where even the administration of analgesia involving a pregnant woman has its untoward consequences.

Despite the results of the survey, Dr. Redelmeier does not advocate that pregnant women cease driving for fear of adverse actions creating circumstances that may result in vehicle collisions. Rather, he stresses the benefit under those conditions of being alert to the potential of distraction and exerting the discipline of awareness.

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