Evaluation of Mother and Fetus after a Traumatic Event: An Overview
Abstract
Trauma due to accidents or violence is a common complication during pregnancies. Every woman in reproductive age who has been admitted due to trauma should be considered pregnant until proven otherwise. A multidisciplinary approach is usually warranted to optimize the outcome for both the mother and her fetus and some headlines should always be taken into consideration when dealing with a pregnant trauma patient. In major trauma, obstetrician consultation should be done as soon as possible. You should not delay indicated radiographic studies due to concerns regarding fetal exposure to radiation. It is preferable to perform one computed tomography (CT) scan with iodinated contrast rather than multiple suboptimal imaging procedures without contrast. Physiologic changes during pregnancy put injured pregnant woman at increased risk, necessitates special attention. In this paper we try to overview on some important aspects of a pregnant trauma patient management.
2. Weinberg L, Steele RG, Pugh R, Higgins S, Herbert M, Story D. The pregnant trauma patient. Anaesth Intensive Care. 2005;33(2):167-80.
3. Abushouk AI, Taheri MS, Pooransari P, Mirbaha S, Rouhipour A, Baratloo A. Pregnancy screening before diagnostic radiography in emergency department; an educational review. Emergency. 2017;5(1):e60.
4. Jain V, Chari R, Maslovitz S, Farine D, Bujold E, Gagnon R, et al. Guidelines for the management of a pregnant trauma patient. J Obstet Gynaecol Can. 2015;37(6):553-71.
5. Schwaitzberg SD. Trauma and Pregnancy. Available from: http://emedicine.medscape.com/article/435 224-overview.
6. Queensland Clinical Guidelines. Trauma in Pregnancy. Available from: https://www.health.qld.gov.au/_ data/assets/pdf_file/0013/140611/g-trauma.pdf.
7. Sadro C, Bernstein MP, Kanal KM. Imaging of trauma: Part 2, Abdominal trauma and pregnancy—a radiologist's guide to doing what is best for the mother and baby. AJR Am J Roentgenol. 2012;199(6):1207-19.
8. Brown S, Mozurkewich E. Trauma during pregnancy. Obstet Gynecol Clin North Am. 2013;40(1):47-57.
9. Australian Radiation Protection and Nuclear Safety Agency. Radiation Protection in Diagnostic and Interventional Radiology. Available from: https://www.arpansa.gov.au/sites/default/files/legacy/pubs/rp s/rps14_1.pdf.
10. Raptis CA, Mellnick VM, Raptis DA, Kitchin D, Fowler KJ, Lubner M, et al. Imaging of trauma in the pregnant patient. Radiographics. 2014;34(3):748-63.
11. Sperry JL, Minei JP, Frankel HL, West MA, Harbrecht BG, Moore EE, et al. Early use of vasopressors after injury: caution before constriction. J Trauma. 2008;64(1):9-14.
12. Pearlman M, Faro S. Obstetric septic shock: a pathophysiologic basis for management. Clin Obstet Gynecol. 1990;33(3):482-92.
13. Wang YC, Chen CH, Su HY, Yu MH. The impact of maternal cardioversion on fetal haemodynamics. Eur J Obstet Gynecol Reprod Biol. 2006;126(2):268-9.
14. Ramsay G, Paglia M, Bourjeily G. When the heart stops: a review of cardiac arrest in pregnancy. J Intensive Care Med. 2013;28(4):204-14.
15. Brun PM, Chenaitia H, Dejesus I, Bessereau J, Bonello L, Pierre B. Ultrasound to perimortem caesarean delivery in prehospital settings. Injury. 2013;44(1):151-2.
16. Queensland Clinical Guidelines. Intrapartum fetal surveillance. Available from: https://www.health.ql d.gov.au/__data/assets/pdf_file/0020/140816/ed-ifs.pdf.
17. Guo SS, Greenspoon JS, Kahn AM. Management of burn injuries during pregnancy. Burns. 2001 Jun 1;27(4):394-7
18. Huls CK, Detlef s C. Trauma in pregnancy . Semin Perinatol. 2018;42(1):13-20.
19. Chu J, Johnston TA, Geoghegan J, Royal College of Obstetricians and Gynaecologists. Maternal Collapse in Pregnancy and the Puerperium: Green‐top Guideline No. 56. BJOG. 2020;127(5):e14-52.
20. Fitzpatrick KE, Tuffnell D, Kurinczuk JJ, Knight M. Incidence, risk factors, management and outcomes of amniotic‐fluid embolism: a population‐based cohort and nested case–control study. BJOG. 2016;123(1):100-9.
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Issue | Vol 5 No 1 (2021): Winter (February) | |
Section | Review article | |
Keywords | ||
Emergency Medicine Multiple Trauma Pregnant Women |
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