Pregnancy Trauma

Trauma in pregnancy has a wide spectrum, ranging from mild (eg, a single fall from standing height or striking the abdomen on an open drawer) to major (penetrating or high force blunt injury such as a motor vehicle accident). Trauma in pregnancy has dramatically increased in the past 25 years and is now the number one cause of nonobstetrical maternal death in the United States. With major trauma, there is a 40% to 50% risk of fetal death. Even with minor trauma, if it occurs during the first or second trimester, there is an increase in delivering a child prematurely or with a low birth weight. Although infrequently encountered in the clinical setting, emergency medicine clinicians, trauma surgeons, obstetricians, and gynecologists should be aware of and prepared to manage a variety of complications associated with trauma in pregnancy. With sufficient knowledge of normal maternal physiology and potential pregnancy-related injury patterns, the clinician facing a pregnant trauma victim can be better equipped to manage them, thus resulting in reduced morbidity and mortality.