ABSTRACT

Correct, adequate and proper time of care of the pregnant trauma patient is extremely important for both fetal and maternal outcomes. When managing the pregnant trauma victim, one must optimize the well-being of two patients, but the health of the mother is of paramount importance. Rapid assessment, treatment, and transport are critical to optimizing maternal and fetal outcome. Evaluation must be performed with an understanding of the physiologic changes that occur in pregnancy. The basic tenets of trauma evaluation and resuscitation should be applied in maternal trauma. Aggressive resuscitation of the mother is the best management for the fetus. Care must be taken to keep the patient in the left lateral decubitus position to avoid compression of the inferior vena cava and resultant hypotension. Radiographic studies should be used with care. Noninvasive diagnostics should be used when available. Cardiotocographic monitoring of a viable gestation should be initiated as soon as possible in the emergency department to evaluate fetal well-being. Urgent cesarean section should be considered if fetal distress is present or if the presence of the fetus is contributing to maternal instability. This article reviews the critical features necessary in the assessment, diagnosis, treatment, and disposition of pregnant trauma patients with a focus on recent developments reported in the literature for emergency management.

Keywords: Trauma, pregnancy, radiology, treatment, fetus