What are the most common types of trauma in pregnancy?
Major trauma has been associated with 7 percent of maternal and 80 percent of fetal mortality. Motor vehicle crashes are the most common cause of blunt trauma in pregnancy, representing 50 percent of cases. Falls due to instability, especially late in pregnancy, represent another 22 percent of injuries.
What is the pathophysiology of trauma in pregnancy?
The normal physiology of the pregnant mother complicates evaluation and management of trauma in pregnancy. The gravid uterus is particularly susceptible to penetrating and blunt force trauma to the abdomen. Motor vehicle accidents account for 50% of all traumatic injuries during pregnancy and 82% of trauma related fetal death.
What is the most common cause of death during pregnancy?
Placental abruption is the most common cause of fetal death from trauma in pregnancy. Force from trauma can sheer the placenta from the uterine wall and lead to fetal demise. Uterine rupture, though rare, usually occurs in the third trimester and is associated with high risk of fetal and maternal mortality.
What is the risk of fetal death from trauma during pregnancy?
With major trauma there is a 40 to 50% risk of fetal death. Even with minor trauma, if it occurs during the first or second trimester there is an increase to delivering a child with prematurity or low birth weight.
Why is it dangerous to fall during pregnancy?
Can falling while pregnant cause brain damage?
What is considered trauma during pregnancy?
Traumatic injuries to pregnant women are unintentional (motor vehicle crashes [48%], falls [25%], poisonings, and burns) or intentional (assaults/intimate partner violence [IPV; 17%], suicide [3.3%], homicide, and gunshot wounds [4%]). Injuries are classified as minor or major trauma.
What are the 2 most common complications during pregnancy?
Some of the most common complications of pregnancy include: high blood pressure. gestational diabetes.
Why is the incidence of trauma during pregnancy rising?
Abstract. Pregnancy ensues a different normal physiology. This changed physiology adds to the vulnerability of mother to trauma. Treating two lives in one patient adds to the responsibility of the treating physician and increases the anxiety of both the patient and the physician.
What is associated with blunt trauma in pregnancy?
Skull fracture is the most common direct fetal injury, with a mortality rate of 42 percent. 12. Altered mental status or severe head injury after trauma in a pregnant woman is associated with increased adverse fetal outcomes. 13. Placental abruptions usually occur from 16 weeks of gestation onward.
What are the 4 most common pregnancy complications?
What are some of the more common complications of pregnancy? Although the majority of pregnancies are uneventful, sometimes complications do happen. ... Amniotic fluid complications. ... Bleeding. ... Ectopic pregnancy. ... Miscarriage or fetal loss. ... Placental complications. ... Preeclampsia or eclampsia.
What are the 4 main pregnancy complications?
The following are some common maternal health conditions or problems a woman may experience during pregnancy—Urinary Tract Infections (UTI) ... Mental Health Conditions. ... Hypertension (High Blood Pressure) ... Obesity and Weight Gain. ... Infections.More items...
What trauma can cause a miscarriage?
Catastrophic trauma includes such types of injury as maternal death, hemorrhagic shock, multiple compound fractures of the extremities, liver and spleen ruptures, to name a few. Catastrophic trauma during the first trimester is often associated with subsequent miscarriage.
What is the most common cause of fetal death?
EtiologyPlacental Abnormalities: Fetal growth restriction and placental abnormalities are the most prevalent findings in stillbirth. ... Diabetes. ... Race. ... Obesity. ... Age. ... Substance Misuse. ... Gestational Age >38 weeks. ... Hypertension.More items...•
How does emotional trauma affect pregnancy?
Clinical studies link pregnant women's exposure to a range of traumatic, as well as chronic and common life stressors (i.e., bereavement, daily hassles, and earthquake), to significant alterations in children's neurodevelopment, including increased risk for mixed handedness, autism, affective disorders, and reduced ...
What happens to the baby when the mother is stressed during pregnancy?
During pregnancy, stress can increase the chances of having a premature baby (born before 37 weeks of pregnancy) or a low-birthweight baby (weighing less than 5 pounds, 8 ounces). Babies born too soon or too small are at increased risk for health problems.
Can babies experience trauma in the womb?
A 2020 study noted that growing babies can be impacted by mood changes, trauma, and complications during pregnancy. Many factors have the potential to interrupt bonding with a child in-utero, including: anticipatory anxiety. financial distress.
How long after trauma does placental abruption happen?
The optimal length of fetal heart rate monitoring following trauma is not clear, but the majority of placental abruptions occur within 6 to 9 hours of the event.
What are 3 complications of pregnancy?
What are some common complications of pregnancy?High Blood Pressure. High blood pressure, also called hypertension, occurs when arteries carrying blood from the heart to the body organs are narrowed. ... Gestational Diabetes. ... Infections. ... Preeclampsia. ... Preterm Labor. ... Depression & Anxiety. ... Pregnancy Loss/Miscarriage. ... Stillbirth.More items...•
What are the 10 danger signs of pregnancy?
Fever. Abdominal pain. Feels ill. Swelling of fingers, face and legs....DANGER SIGNS DURING PREGNANCYvaginal bleeding.convulsions/fits.severe headaches with blurred vision.fever and too weak to get out of bed.severe abdominal pain.fast or difficult breathing.
What pregnancies are high risk?
A woman's pregnancy might be considered high risk if she:is age 17 or younger.is age 35 or older.was underweight or overweight before becoming pregnant.is pregnant with twins, triplets, or other multiples.has high blood pressure, diabetes, depression, or another health problem.More items...
What are major diseases during pregnancy?
What health problems can develop during pregnancy?Iron Deficiency Anemia. Anemia occurs when your red blood cell count (hemoglobin or hematocrit) is low. ... Gestational Diabetes. ... Depression and Anxiety. ... Fetal Problems. ... High Blood Pressure Related to Pregnancy. ... Infections. ... Hyperemesis Gravidarum. ... Miscarriage.More items...•
How many pregnancies are traumatized?
Trauma is sustained in 8% of all pregnancies. Regardless of mechanism, trauma can be life threatening for both the mother and fetus. Rapid evaluation and treatment of the mother in trauma should be even further heightened, as maternal shock is associated with an 80% fetal mortality.
How does domestic violence affect pregnancy?
Domestic violence increases during pregnancy, placing the mother and the fetus at obvious risk for injury. Domestic violence occurs in 4 to 8% of pregnancies and is associated with 5% risk of fetal death. The normal physiology of the pregnant mother complicates evaluation and management of trauma in pregnancy.
What is the most common cause of fetal death?
Preterm labor in general should be treat with standard obstetric protocol. Next to maternal death, placental abruption is the next most common cause of fetal death. Non-reassuring fetal heart tones with clinical evidence concerning for placental abruption warrants emergent cesarean section. In addition to placental abruption , severe pelvic or spine fractures, fetal malposition with premature labor, maternal disseminated intravascular coagulation, and gravid uterus when interfering with exposure of potential injuries / exposure during laparotomy are all indications for emergent cesarean section. The uterus is exposed through midline vertical celiotomy. The uterus itself is incised vertically with scissor, exposing the infants head with immediate suction of the oropharynx as the infant is delivered. The umbilical cord is subsequently clamped and divided. The placenta is next manually removed with inspection of the endometrium to ensure no retained membrane present. The uterus is then closed in layers with a running absorbable stitch. Oxytocin (Pitocin) may be administered for post-partum bleeding.
What is the gravid uterus?
The gravid uterus is particularly susceptible to penetrating and blunt force trauma to the abdomen. Motor vehicle accidents account for 50% of all traumatic injuries during pregnancy and 82% of trauma related fetal death. The main reason for this equates to the improper use of seat belts.
What is premature labor?
Premature labor is defined as the presence of uterine contractions occurring at less than 36 weeks’ gestation (premature) accompanied by cervical changes (labor). Although trauma patients may feel pain similar to real labor contractions, these pains may not represent contractions. Toconometry is indicated to determine if the contractions are real. The most common cause is placental abruption (see below). If contractions are present, the diagnosis of placental abruption must be considered and investigated, as well as uterine rupture and other hemorrhage. If present, correction of hypoxia and hypovolemia should occur as these are common causes of premature labor.
What is advanced trauma life support?
Advanced Trauma Life Support principles remain the same whether the patient is non-gravid or full-term. As always, taking care of the maternal patient will, in turn, take care of the fetus. The best early treatment of the fetus is the optimal resuscitation of the mother. Upon determining of gravidity consultation with obstetrics is critical. Nearly all female patients between the ages of 10 and 55 years warrant Beta-human chorionic gonadotropin (HCG) testing. Transfer to an appropriate trauma center with applicable obstetrical specialized care has demonstrated improved maternal and neonatal outcomes post injury as opposed to non trauma centers.
How rare is uterine rupture?
Abruption is thought to complicate 1-6% of minor injuries and up to 50% of major injuries. Uterine rupture is overall rare, occurring in less than 1% of pregnant trauma patients, and is most commonly associated with direct impact with sustained force to a previously scarred uterus.
What percentage of trauma occurs during pregnancy?
Though the rates of intimate partner violence or assaults rise during pregnancy, these account for only 2 to 3 percent of total traumas in pregnancy. When injury occurs, the mother's pregnant anatomy provides excellent fetal protection, with the thick uterine walls and amniotic fluid helping prevent shock.
What is the first goal of traumatized pregnant women?
The first goal is to assess the maternal airway, breathing and circulation and establish maternal-cardiopulmonary stability; resuscitating the mother will optimize fetal outcomes.
Why is it important to ask the mother about fetal movement?
Due to difficulty determining whether direct injury to the fetus has occurred, asking the mother about fetal movement and utilizing monitors can provide additional needed data beyond clinical exam.
What is the most common cause of maternal death?
Risk of fetal and maternal death from trauma. Placental abruption is the most common cause of fetal death from trauma in pregnancy. Force from trauma can sheer the placenta from the uterine wall and lead to fetal demise. Uterine rupture, though rare, usually occurs in the third trimester and is associated with high risk ...
What percentage of maternal deaths are caused by trauma?
Major trauma has been associated with 7 percent of maternal and 80 percent of fetal mortality.
How long should pregnant women be monitored after trauma?
If no injuries are identified, pregnant patients should be monitored for six hours, or even longer in higher level injury cases or fetal distress.
What test is performed to determine if a pregnant woman has a traumatic injury?
Also essential to the care of pregnant females with traumatic injury is performing blood typing to determine Rh (D) status. Rh (D)-negative women with major trauma who are not already alloimmunized should receive anti-D immune globulin. A Kleihauer-Betke test can be performed to determine whether any maternal-fetal blood exchange has occurred.
What is the most common pregnancy complication?
Placental abruption is the most common pregnancy complication, and may occur with even minor mechanisms of injury. Increasing severity of trauma increases the frequency of abruption, admission, delivery, and fetal demise.
What is the leading non-obstetric cause of death during pregnancy?
Trauma is the leading non-obstetric cause of death during pregnancy and approximately 6-8% of all pregnancies are complicated by injury, both accidental and intentional. The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to pr …. Trauma is the leading non-obstetric cause of ...
What is the role of a multidisciplinary team in a pregnant woman?
The initial evaluation and management of the injured pregnant patient often requires a multidisciplinary, collaborative team to provide the optimal outcome for both mother and fetus. It is important to recognize that even minor mechanisms of injury may result in poor outcomes for both fetus and mother.
Why is it dangerous to fall during pregnancy?
Falls during pregnancy are a typical source of minor injuries and, in certain situations, can be dangerous to both you and your baby. During pregnancy, your body is intended to safeguard your developing baby. Your uterine walls are thick, powerful muscles that assist keep your baby secure. Am niotic fluid also acts as a cushion. If you fall and damage your belly button or cervix, the force of the impact may rupture these areas of your womb, allowing blood and other fluids to leak into your body.
Can falling while pregnant cause brain damage?
Fetal brain damage almost often result in fetal death. Women who are involved in such accidents should not drive for at least six months after the accident. They should also avoid any other kinds of strenuous activity as this too can lead to serious complications for the mother and baby.
Risk of Fetal and Maternal Death from Trauma
- Placental abruption is the most common cause of fetal death from trauma in pregnancy. Force from trauma can sheer the placenta from the uterine wall and lead to fetal demise. Uterine rupture, though rare, usually occurs in the third trimester and is associated with high risk of fetal and maternal mortality. "Even a minor injury can lead to fetal lo...
Managing Trauma in Pregnancy
- Managing a case of trauma in pregnancy can be an emotionally charged situation. "Any time you are dealing with two patients coming in as one, you are dealing with a higher stress situation," says Dr. Loomis, adding that sometimes expectant mothers facing traumatic injury can be hysterical, and family members with passions running high can be distracting. If available, reque…
Other Pitfalls
- Beyond distraction by the fetus, there are several other potential pitfalls to avoid while treating expectant mothers, such as:
The Question of Transfer
- Whether a pregnant patient who has suffered trauma should be transferred to a higher level of care depends on her pregnancy stage and the treating hospital's resources. A few key questions to determine need for transfer include: 1. Is the needed blood supply available? 2. Is vaginal bleeding or membrane rupture present that may require neonatal delivery? 3. Is the local obstetri…