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Trauma in Pregnancy

OXFORD, CORRINA M. MD*; LUDMIR, JONATHAN BA

Clinical Obstetrics and Gynecology: December 2009 - Volume 52 - Issue 4 - p 611-629
doi: 10.1097/GRF.0b013e3181c11edf
Surgical Intervention in Pregnancy

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.

*Brigham and Women's Hospital, Harvard School of Medicine, Boston, Massachusetts

University of Pennsylvania, School of Medicine, Philadelphia, Pennsylvania

Correspondence: Corrina M. Oxford, MD, Brigham and Women's Hospital, Harvard School of Medicine, 75 Francis Street, Boston, MA 02115. E-mail: coxford@partners.org

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's web site, www.clinicalobgyn.com.

© 2009 Lippincott Williams & Wilkins, Inc.