Trauma in pregnancy

Abstract

Trauma is complicating 1 in 12 pregnancy and is considered to be the first cause of non-obstetrical maternal death. Frequently encountered complications are preterm delivery, placental abruption or spontaneous abortion. Presence of the gravid uterus is a major contributor that increases the risk of the occurrence of possible wounds, and as the pregnancy progresses, multiple changes that occur can make the management of the pregnant patient harder. Studies have shown that domestic abuse should not be overlooked. First evaluation needed for pregnant trauma woman comprise complete blood count, coagulation profile, Rh factor de-termination, urine analysis, electrolytes and glucose, toxicology screening and the Kleinhauer-Betke (KB) test. Also, diag-nostic imaging is not discouraged, and may raise and also confirm the suspicion for placental abruption or uterine rup-ture. In case of cardiac arrest and unsuccessful resuscitation of the mother within 4 minutes, literature recommends a peri-mortem cesarean delivery, if gestational age is above 23 weeks and the fetus is potentially viable.