Trauma In Pregnancy

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Trauma In Pregnancy

• Temple College
• EMS Professions

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Trauma

• Leading cause of death during pregnancy
• MVAs cause 50 of prenatal mortality
• Consider possible pregnancy in any female trauma
  patient of childbearing age

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Trauma In Pregnancy

• Priorities same as in non-pregnant patient
• ABCs

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Trauma In Pregnancy

• Most common cause of fetal death from trauma is
  maternal death
• Whats good for mom is good for baby!!

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Alterations In Pregnancy

• As pregnancy progresses
• Heart rate increases
• Blood pressure decreases
• Normal pregnant vital signs mimic hypoperfusion
• Assessment more difficult

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Alterations In Pregnancy

• Blood volume increases by 40-50
• 30 blood loss may occur before shock signs and
  symptoms develop
• Reversal of hypoperfusion more difficult

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Alterations In Pregnancy

• Blood flow to uterus, placenta can be selectively
  reduced
• Fetus can be in distress while mother appears
  stable
• Adequate resuscitation of mom does NOT ensure
  adequate resuscitation of baby

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Alterations In Pregnancy

• Uterus can compress inferior vena cava when
  patient is supine
• Decreases cardiac output 30 - 40
• Do NOT put pregnant patients in supine position!

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Management

• Airway
• C-spine control
• High flow O2
• 3rd trimester O2 demand increases 10-20
• Assist ventilation

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Management

• If MAST used, inflate legs only
• Transport patient
• on left side, or
• elevate right side of spine board