Trauma in Pregnancy
When confronted with the pregnant trauma patient a unique challenge presents itself, largely due to the fact care must be provided for two patients—the mother and the unborn child. Many Anatomical and physiological changes occur in pregnancy which can mask or mimic injury, the mechanism of injury may also indicate possible, unseen, trauma to enlarged or naturally displaced organs (due to foetal growth) especially during the third trimester.
Domestic violence and road traffic collisions (RTC's) are the main causes of trauma in pregnancy
REMEMBER
- When dealing with the pregnant patient be aware all trauma is significant
- Due to increased vascular volume signs of shock may appear very late
- If the patient is found or goes into cardiac arrest commence life support as this treatment will not only resuscitate the mother but also the foetus and allow an emergency C-Section on arrival at hospital
Management
Administer high levels of supplemantal oxygen aiming for target saturations of 94-98%. Provide assisted ventilations if indicated, To prevent inferior vena cava compression it will be necessary to manually displace the uterus to the left or tilt the patient to the left by 15-30 degrees, Manage pain with the use of Entonox if indicated, Apply appropriate splintage for pelvic or long bone fractures, Measure blood glucose levels
ASHICE (Consider)
Transport to Hospital (Smooth journey to prevent further complications and discomfort)
Professional Handover