Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-669899f699-2mbcq Total loading time: 0 Render date: 2025-05-02T10:39:26.611Z Has data issue: false hasContentIssue false

Chapter 35 - Major Trauma Including Road Traffic Accidents

from Section 6 - Anaesthetic Emergencies During Pregnancy

Published online by Cambridge University Press:  06 May 2021

By
Kirsty Crocker  and
Tim Patel
Edited by
Edwin Chandraharan  and
Sir Sabaratnam Arulkumaran
Edwin Chandraharan
Affiliation:
St George's University of London
Sir Sabaratnam Arulkumaran
Affiliation:
St George's University of London
Get access

Summary

Blunt trauma is the most common type of trauma in pregnancy, being caused mainly by road traffic accidents. Different mechanisms of injury give rise to a variety of injury patterns. Blunt forces commonly cause compression injuries, particularly laceration or fracture of solid organs. Sudden deceleration and consequent shearing forces cause avulsion of peritoneal attachments or arteries. Rapid increase in abdominal pressure, for example from a seat belt, can result in hollow viscus rupture or rib or pelvic fractures and cause laceration injuries.

Type
Chapter
Information
Obstetric and Intrapartum Emergencies
A Practical Guide to Management
 , pp. 252 - 260
Publisher: Cambridge University Press
Print publication year: 2021

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Book purchase

Temporarily unavailable

References

Connolly, AM, Katz, VL, Bash, KL, McMahon, MJ, Hansen, WF. Trauma and pregnancy. Am J Perinatol. 1997;14(6):331–6.CrossRefGoogle ScholarPubMed
Centre for Maternal and Child Enquiries (CMACE). Saving Mothers’ Lives: Reviewing Maternal Deaths to make Motherhood Safer – 2006–2008. The Eighth Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. Br J Obstet Gynaecol. 2011;118(Suppl. 1):1–208.CrossRefGoogle Scholar
Davis, JJ, Cohn, I. Diagnosis and management of blunt abdominal trauma. Ann Surg. 1976;183:672.CrossRefGoogle ScholarPubMed
Shah, AJ, Kilcline, BA. Trauma in pregnancy. Emerg Med Clin North Am. 2003;21(3):615–29.Google Scholar
Esposito, TJ, Gens, DR, Smith, LG, Scorpio, R. Evaluation of blunt abdominal trauma occurring during pregnancy. J Trauma. 1989;29(12):1628–32.CrossRefGoogle ScholarPubMed
Rothenberger, D, Quattlebaum, FW, Perry, JF Jr, Zabel, J, Fischer, RP. Blunt maternal trauma: review of 103 cases. J Trauma. 1978;18(3):173–9.CrossRefGoogle ScholarPubMed
Werman, HA, Falcone, RE. Trauma in pregnancy. Emerg Med Rep Pediatr Emerg Med Rep. 2008;9(4, Suppl).Google Scholar
Buchsbaum, H (ed.) Penetrating injury of the abdomen. In Trauma in Pregnancy. Philadelphia: WB Saunders; 1979, 82–100.Google Scholar
Awwad, JT, Azar, GB, Seoud, MA, Mroueh, AM, Karam, KS. High velocity penetrating wounds of the gravid uterus: review of 16 years of civil war. Obstet Gynecol. 1994;83:259–64.Google ScholarPubMed
Meunch, MV, Canterino, JC. Trauma in pregnancy. Obstet Gynecol Clin North Am. 2007;34(3):555–83.Google Scholar
Matthews, RM. Obstetric implications of burns in pregnancy. Br J Obstet Gynecol. 1982;89:603–9.Google ScholarPubMed
Akhtar, MA, Mulawakar, PM, Kulkarni, HR. Burns in pregnancy: effect on maternal and foetal outcomes. Burns. 1994;20:351–5.Google Scholar
Howell, C, Grady, K, Cox, C. Managing Obstetric Emergencies and Trauma: The MOET Course Manual, 2nd ed. London: RCOG, 2007.Google Scholar
US Army Institute of Surgical Research. Joint Theater Trauma System Clinical Practice Guideline: Damage control resuscitation at level IIb and III treatment facilities. December 21, 2014.Google Scholar
Holcomb, JB, Tilley, BC, Baraniuk, S; PROPPR Study Group. Transfusion of plasma, platelets, and red blood cells in a 1:1:1 vs a 1:1:2 ratio and mortality in patients with severe trauma: the PROPPR randomized clinical trial. JAMA. 2015;313(5):471–82.CrossRefGoogle Scholar
WOMAN Trial Collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet. 2017;389(10084):2105–16.Google Scholar
Roberts, I, Shakur, H, Afolabi, A, et al. The importance of early treatment with tranexamic acid in bleeding trauma patients: an exploratory analysis of the CRASH-2. Randomised controlled trial. Lancet. 2011; 377(9771):1096.Google ScholarPubMed
Stephansson, O, Dickman, PW, Johansson, A, Cnattingius, S. Maternal hemoglobin concentration during pregnancy and risk of still birth. JAMA. 2000;284:2611–17.CrossRefGoogle Scholar
Resuscitation Council (UK). Adult Advanced Life Support Guidelines – UK Resuscitation Guidelines 2010. www.resus.org.uk/pages/guide.htmGoogle Scholar
Eposito, TJ. Trauma during pregnancy. Emerg Med Clin North Am. 1994;12:167–199.Google Scholar
Pearlman, MD, Tintinalli, JE. Evaluation and treatment of the gravida and fetus following trauma during pregnancy. Obstet Gynecol North Am. 1991:18:371–81.Google ScholarPubMed
Incerpi, M. Trauma in pregnancy. In Murphy Goodwin, T, Montoro, MN, Muderspach, L, Paulson, R, Roy, S (eds.), Management of Common Problems in Obstetrics and Gynecology, 5th ed. Chichester: Wiley-Blackwell; 2010, 156–9.Google Scholar
American College of Obstetricians and Gynaecologists. ACOG Technical Bulletin Number 161. Trauma during pregnancy. November 1991. Int J Gynaecol Obstet. 1993;40(2):165–70.Google Scholar
American College of Obstetricians and Gynaecologists. Guidelines for Diagnostic Imaging during Pregnancy. Committee Opinion 158. September 1995.Google Scholar
Hall, EJ. Scientific view of low radiation risks. Radiographics. 1991;11:509–18.CrossRefGoogle ScholarPubMed
Rothenberger, DA, Quattlebaum, FW, Zabel, J, Fischer, RP. Diagnostic peritoneal lavage in blunt trauma in pregnant women. Am J Obset Gynecol. 1977;129(5):479–81.CrossRefGoogle ScholarPubMed
Chames, MC, Pearlman, MD. Trauma during pregnancy: outcomes and clinical management. Clin Obstet Gynaecol. 2008;51:398–408.CrossRefGoogle ScholarPubMed
Pearlman, MD, Tintinalli, JE, Lorenz, RP. A prospective controlled study of outcome after trauma during pregnancy. Am J Obstet Gynecol. 1990;162:1502–7.CrossRefGoogle ScholarPubMed
Pearlman, MD, Phillips, ME. Safety belt use in pregnancy. Am J Obstet Gynecol. 1996;88:1026–9.Google Scholar
Pearlman, MD, Viano, D. Automobile crash simulation with the first pregnant crash test dummy. Am J Obstet Gynecol. 1996;175:977–81.CrossRefGoogle ScholarPubMed
Schiff, MA, Mack, CD. The effect of airbags on pregnancy outcomes in Washington State 2002–2005. Obstet Gynecol. 2010;115(1):85–92.CrossRefGoogle ScholarPubMed
McFarlane, J, Campbell, JC. Abuse during pregnancy and femicide: urgent implications for womens health. Obstet Gynecol. 2002;100(1):27–36.Google Scholar
The Confidential Enquiry into Maternal and Child Health (CEMACH). Saving mothers’ lives: reviewing maternal deaths to make motherhood safer – 2003–2005. The Seventh Report on Confidential Enquiries into Maternal Deaths in the United Kingdom. London: CEMACH; 2007.Google Scholar
Deakin, CD, Low, JL. Accuracy of the advanced trauma life support guidelines for predicting systolic blood pressure using carotid, femoral, and radial pulses: observational study. Br Med J. 2000;321(7262):673–74.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×