Initial trauma management in advanced pregnancy.
The principles enshrined in existing trauma resuscitation protocols for treating nonpregnant trauma victims should also be applied to the pregnant patient. In addition, left tilt of the pregnant patient (or the back board) and supplement oxygen are mandatory. The patient should be treated by a multidisciplinary team, preferably in a trauma center. Early intubation is recommended, but should be performed, where possible, by an experienced physician. The physician should be aware of the different physiologic and laboratory values in normal pregnancy. Fetal monitoring is important to assess both fetal and maternal welfare. Imaging examinations, where indicated, should not be delayed. Even minor maternal trauma, especially if caused by interpersonal violence, might cause fetal loss.
Meroz
Yuval
Y
Department of Anesthesiology and Critical Care Medicine, Hadassah Hebrew University Medical Center, POB 12000, Ein Karem, Jerusalem 91120, Israel.
Elchalal
Uriel
U
Ginosar
Yehuda
Y
D000328:Adult; D000818:Animals; D002585:Cesarean Section; D004632:Emergency Medical Services; D005260:Female; D005313:Fetal Death / Q000453:epidemiology / Q000517:prevention & control; D005333:Fetus / Q000502:physiology; D006801:Humans; D007442:Intubation, Intratracheal; D011247:Pregnancy; D011248:Pregnancy Complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D011859:Radiography; D012306:Risk; D014599:Uterus / Q000293:injuries / Q000503:physiopathology; D014947:Wounds and Injuries / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*