newborn | Acta Medica Marisiensis

Maternal car accidents during pregnancy and their impact on newborns

Claudia Kosztelnik¹, Manuela Camelia Cucerea^2,3

1. Neonatology Department, Bistrita Emergency County Clinical Hospital, Bistrita, Romania
2. Neonatology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Neonatology Department, Mures Clinical County Hospital, Targu Mures, Romania

DOI: 10.2478/amma-2025-0047

Introduction: Car accidents are among the most common causes of fetal trauma during pregnancy. The most frequent maternal complications include placental abruption, uterine rupture, and hypovolemic shock, while fetal complications include premature birth, cranial injuries, skull fractures, and even death.
Objective: To examine how car accidents affect pregnant women and their newborns.
Methods: Three cases of newborns delivered by mothers involved in car accidents during pregnancy were analyzed. The data were collected from the medical records of the neonatology department.
Results: These three clinical cases demonstrate the significant impact of maternal trauma from car accidents on perinatal outcomes and neonatal development, with a wide range of clinical manifestations, from transient neonatal complications to neonatal death. Properly using seatbelts during pregnancy is essential to prevent injuries to both the mother and the fetus.
Conclusions: Maternal motor vehicle accidents can have severe and diverse consequences for newborns, ranging from transient complications to congenital malformations and neonatal death. Proper and correct use of seatbelts during pregnancy is a critical preventive measure to reduce maternal and fetal injuries. Immediate neonatal resuscitation and thorough post-trauma evaluation, are essential for improving outcomes. Long-term pediatric monitoring is recommended due to the risk of delayed complications. Further research is needed to develop standardized protocols for trauma management in pregnancy and to better understand the effects of intrauterine trauma on fetal development.

Challenges in the management of a preterm neonate with respiratory distress and pneumothorax: A case report

Mihaela Maria Celsie¹, Manuela Cucerea^2,3

1. Bistrita Emergency County Clinical Hospital, Bistrita, Romania
2. Neonatology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, Romania
3. Neonatology Department, Mures Clinical County Hospital, Targu Mures, Romania

DOI: 10.2478/amma-2025-0048

Introduction: Pneumothorax is a potentially life-threatening complication in preterm neonates, frequently associated with respiratory distress syndrome (RDS). Prompt diagnosis and individualized respiratory support are essential to avoid invasive interventions.
Objective: To describe the successful conservative management of a preterm neonate with respiratory distress syndrome complicated by pneumothorax and congenital infection, emphasizing the role of early respiratory support and infection control.
Methods: A male infant was born prematurely with clinical signs of systemic inflammation and respiratory distress. Initial management in the delivery room included thermal stabilization, tactile stimulation, and continuous positive airway support. Blood gas analysis revealed mild mixed acidosis. Chest radiography confirmed pneumothorax and respiratory distress syndrome. The patient was managed conservatively with intratracheal surfactant (100 mg per kilogram per dose), right lateral positioning and high-frequency oscillatory ventilation, without pleural drainage.
Results: The patient responded favorably to supportive management. Respiratory status improved progressively. Oxygen requirements decreased rapidly, and the pneumothorax resolved without invasive intervention. Extubation was achieved on the second day of life, and oxygen therapy was stopped by day six. The patient remained hemodynamically stable, tolerated enteral feeding, and showed appropriate weight gain. On day seven, he was transferred to the neonatal prematurity unit for continued monitoring of growth and jaundice.
Conclusions: This case supports the safety and effectiveness of conservative management in selected preterm neonates with pneumothorax. Early surfactant administration combined with high-frequency oscillatory ventilation (HFOV) can facilitate recovery while avoiding the risks associated with pleural drainage [2]. Tailored respiratory strategies and early control of systemic infection are essential for optimizing outcomes in vulnerable neonates.