Trauma in Pregnancy

Abstract

In the United States, trauma is the leading nonobstetric cause of maternal death. The principal causes of trauma in pregnancy include motor vehicle accidents, falls, assaults, homicides, domestic violence, and penetrating wounds. The managing team evaluating and coordinating the care of the pregnant trauma patient should be multidisciplinary so that it is able to understand the physiologic changes in pregnancy. Blunt trauma to the abdomen increases the risk of placental abruption. Evaluation of the pregnant trauma patient requires a primary and secondary survey with emphasis on airway, breathing, circulation, and disability. The use of imaging studies, invasive hemodynamics, critical care medications, and surgery, if necessary, should be individualized and guided by a coordinating team effort to improve maternal and fetal conditions. A clear understanding of gestational age and fetal viability should be documented in the record.

Motor vehicle collision‐related accidents in pregnancy

“…[3][4][5][6] Further, several non-population-based US studies have shown that blunt physical trauma, the majority of which are attributed to MVA, is the leading cause of non-obstetrical maternal mortality. 1,3,7,8 Moreover, motor vehicle crashes represent an important cause of perinatal mortality with an incidence of fetal/neonatal death at 3.7 per 100 000 pregnancies, attributable in large part to placental abruption and uterine rupture. 9 Despite the potentially significant and life-threatening implications for mother and baby, there is a paucity of data available regarding maternal injuries and outcomes in pregnant women having had an MVA.…”

Maternal Deaths in NSW (2000–2006) from Nonmedical Causes (Suicide and Trauma) in the First Year following Birth

“…Trauma, including suicide, accidental injury, motor traffic accidents, and homicides, is the leading nonobstetric cause of late maternal death in the United States [10] and accounted for 73% of all maternal deaths (early and late) in NSW over an eight-year study period [3]. These nonmedical deaths, and most notably, the late maternal deaths, are underreported [11] and are not as well documented or acknowledged as the obstetric causes listed above.…”

In the Aftermath of Disasters: The Impact on Women’s Health

“…Eighty-two percent of fetal deaths occur from motor vehicle accidents (MVA). Other causes of fetal death from maternal trauma occur because of gunshot wounds (6%), falls (3%), and maternal death (11%) [28].…”