Trauma in Pregnancy

Raja, Ali S.; Zabbo, Christopher P.

doi:10.1016/j.emc.2012.08.003

Cited by 13 publications

(21 citation statements)

References 26 publications

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“…Current maternal CPR or CPR guidelines advocate manual left uterine displacement or firm wedge left lateral shift during maternal chest compression . The combination of a reduction in functional residual capacity due to diaphragmatic displacement by the gravid uterus and the elevated metabolic demand in pregnancy make the pregnant woman susceptible to rapid development of hypoxemia . During CPR, only 25–40% of the cardiac output is generated by chest compression ; thus, additional compromise imposed on this minimal generated cardiac output by the enlarged uterus, may be critical.…”

Section: Resultsmentioning

confidence: 99%

Perimortem cesarean section for maternal and fetal salvage: concise review and protocol

Drukker

Hants

Einav

et al. 2014

Acta Obstet Gynecol Scand

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Cardiopulmonary arrest is a rare event during pregnancy and labor. Perimortem cesarean section has been resorted to as a rare event since ancient times; however, greater awareness regarding this procedure within the medical community has only emerged in the past few decades. Current recommendations for maternal resuscitation include performance of the procedure after five minutes of unsuccessful cardiopulmonary resuscitation. If accomplished in a timely manner, perimortem cesarean section can result in fetal salvage and is also critical for maternal resuscitation. Nevertheless, deficits in knowledge about this procedure are common. We have reviewed publications on perimortem cesarean section and present the most recent evidence on this topic, as well as recommending our "easy-to-access protocol" adapted for resuscitation following maternal collapse.

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Section: Resultsmentioning

confidence: 99%

Perimortem cesarean section for maternal and fetal salvage: concise review and protocol

Drukker

Hants

Einav

et al. 2014

Acta Obstet Gynecol Scand

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“…PA is primarily a clinical diagnosis, based on suspicion [6,17,20,26]. Signs may be abdominal pain, vaginal bleeding or leakage of amniotic fl uid, back pain, uterine tenderness with regular uterine contractions and contraction severity being out of proportion to cervical dilatation, a large uterus, or maternal hypovolemia [2,4,6,7,[9][10][11]15,[17][18][19][20]. The amount of vaginal bleeding does not indicate the severity of PA as the uterine cavity can accommodate the entire blood volume [15,20].…”

Section: Placental Abruptionmentioning

confidence: 99%

“…However, detecting PA may be challenging because signs are often absent, especially following minor trauma [11,19,20,26].…”

Section: Placental Abruptionmentioning

confidence: 99%

“…Ultrasound may also help diagnosing PA since its positive predictive value is high, although its NPV is low [1,2,4,6,7,10,11,14,15,[17][18][19][20][21]26]. It may show a retro-or preplacental haematoma, increased placental thickness, or a subchorionic or marginal collection.…”

Section: Placental Abruptionmentioning

confidence: 99%

“…More than 20-24 weeks pregnancy: uterine compression of inferior vena cava in supine position [1,2,4,5,6,8,9,10,11,14,17,18,20,21,23] Decreased preload and cardiac output (= Supine hypotensive syndrome), especially when hypovolemic [,2,4,5,6,9,10,14,18,19,20,22] Increase in venous pressure below uterus with venous pooling: exacerbation of pelvic, placental or lower extremity bleeding and predisposing to DVT [4,9,10] Further compromise of cardiac output during CPR [1,6,24,25] Enlarged uterus with thinning wall [4,7,10,13,22] Fetus becomes most anterior structure in abdomen [22] Increased risk of direct trauma to uterus, fetus and placenta possibly leading to uterine rupture, placental abruption and fetal injury [4,7,10,13,14,19,20] Increased sacroiliac joint and symphysis laxity with widening of the joints Weight gain and increased lordosis [4,5,6,10,15,17,19,22] Gait instability with predisposal to falls…”

Section: Renal Changesmentioning

confidence: 99%

See 2 more Smart Citations

Management of the pregnant trauma patient: A literature study

Argent¹,

Verelst²,

Sabbé³

2020

Open J Trauma

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Background Trauma complicates approximately 7 % of pregnancies and is thereby the leading cause of non-obstetric morbidity and mortality during pregnancy [1-10]. The risk of traumatic injury increases with the advancement of pregnancy [4,8,10,11]. Pregnancy as such does not increase morbidity or mortality following trauma but leads to different mechanisms and patterns of injury with an increased vulnerability to abdominal injury [4,6,10,12]. One needs to bear in mind that trauma affects both mother and unborn child, with the latter having a higher mortality rate [4,13]. The spectrum of trauma severity is broad. Severe trauma often leads to fetal loss but minor trauma is responsible for the majority (60-70%) of fetal deaths due to its higher prevalence [2,4,10,12,14]. However, the likelihood of adverse fetal outcome is often unpredictable and does not correlate with the degree of trauma [4,15,16].

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