Trauma In Pregnancy Flashcards
What are the 2 main types of trauma in pregnancy?
- Blunt: MVA, falls, domestic violence
2. Penetrating: gunshot, stab
Hormone produced in the 3rd trimester of pregnancy that relaxes pelvic muscles but makes uterus more unstable.
Relaxin
Most common cause of fetal death in MVA trauma.
Maternal shock
Mechanism of placental rupture in trauma.
Elastic myometrium and inelastic placenta are separated by a sheering motion.
Distinguishing factors that indicate placental abruption resulting from trauma.
Dark blood vaginal discharge with constant abdominal pain.
can be no blood if the hemorrhage is concealed
In a pregnant patient, how long is the uterus protected by the bony pelvis?
first 12 weeks
Why does pregnancy usually lead to a physiologic anemia?
Maternal blood increases a total of 45%. The RBCs do not increase proportionately with the plasma, however, and an apparent anemia occurs.
What cardiac effects are seen in pregnancy: CO, HR, BP?
CO: increases from 1L/min to 6L/min by week 10
HR: increases 20bpm in 2nd trimester
BP: decreases in 1st trimester but returns to normal in the 3rd
What is important to remember when treating pregnant patients with respiratory distress?
Chest tube placement is usually 1-2 intercostal spaces higher than normal (5th space) because the abdominal contents have been pushed superior.
1 goal for treating trauma in pregnancy.
Stabilize the mother, fetal survival depends on the mother.
What is the dosing method for Rhogam?
300ug for every 15-30cc of fetal blood mixed with maternal blood.
How is delivery of a baby in trauma managed?
Less than 24 weeks gestation:
-no C-section, infant won’t survive, stabilize mother
24-25 weeks: C-section benefits mom and baby
after 32 weeks: try CPR, if that doesn’t work, do a C-section
