Trauma in pregnancy.
Trauma is the leading nonobstetric cause of maternal mortality. The basic tenets of trauma evaluation and resuscitation should be applied in maternal trauma. Aggressive resuscitation of the mother is the best management for the fetus. Care must be taken to keep the patient in the left lateral decubitus position to avoid compression of the inferior vena cava and resultant hypotension. Radiographic studies should be used with care. Noninvasive diagnostics should be used when available. Cardiotocographic monitoring of a viable gestation should be initiated as soon as possible in the emergency department to evaluate fetal well-being. Urgent cesarean section should be considered if fetal distress is present or if the presence of the fetus is contributing to maternal instability.
Muench
Michael V
MV
Department of Obstetrics, Gynecology and Reproductive Sciences, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson School of Medicine, 125 Paterson Street, New Brunswick, NJ 08901, USA. mvmuench@comcast.net
Canterino
Joseph C
JC
D002585:Cesarean Section; D004632:Emergency Medical Services; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*; D014947:Wounds and Injuries / Q000209:etiology / Q000503:physiopathology* / Q000628:therapy*