Common

complication
and significant
fraction

Radiologic
No Level 1
exam can be
used Evidence
Key
Points

Initial maternal
Multidisciplinary stabilization >
approach Fetal
Assesment
 Trauma includes both intentional harm and
accident
intentional harm >> encompasses assault, blunt
force trauma and penetrating trauma. While
accidents include predominantly, motor vehicle
crashes and fails
In pregnancy is still unclear
US 8 % from any physical trauma to 0.2 to 2 % (evaluation for
trauma) to 0.4-2/10000 (hospitalization for trauma)
Population based study in sweden, calculated a ratio of 207
MVC per 100000 pregnancies
US
73 % MVA (motor vehicle accident )
12 % assault
9% fall
2% bicycle
< 1 % suicide
3% Other (unintentional)
 Higher degree of severity Injury severity score
(ISS) > 9
Lactate > 2 mmol/L
Alered Mental Status (GCS at Admission)
Lack of proper seatbelt use
Severe head injury
Injury to thorax, abdomen, lower extremities or
spine
 0.1 to 1.4% associated with trauma
In the pregnant women hospitalized after
trauma the fatality rate is 2%-4%
About 27% of maternal deaths are injury
related
Fetal Death
The single most salient risk factor for fetal
death is maternal death.
 Airway
Maternal Breathing
Circulation
stabilization Disability
Exposure
The focused abdominal sonogram for trauma
(FAST) is commonly undertaken as part of an
initial assessment in the ER
 Indications for beginning cardiopulmonary resuscitation
(CPR) are no different in pregnant patients

If the CPR has no return of spontaneous circulation,

perimortem cesarean delivery (PMCD) should be
performed for patients at later gestational ages.

Overall neonatal survival after PMCD was 64%

even when delivery occurred more than 10 minutes
after maternal arrest