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Trauma in Pregnancy

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Emergency Department Management of Obstetric Complications

Abstract

Motor vehicle collisions, falls, and intimate partner violence are responsible for the majority of non-obstetric fatalities during pregnancy. The mother’s life takes priority in trauma resuscitation. There are specific anatomical and physiological changes that are unique to the pregnant patient that must be recognized when performing rapid sequence intubation or chest tube thoracostomy, as well as in the interpretation of radiological studies, EKG, and laboratory tests. Left lateral positioning and avoidance of hypoxia and hypotension are critical to providing optimal maternal care. Trauma computed tomography studies confer ionizing radiation doses below 50 mGy, whereas levels between 100 and 200 mGy have shown to be teratogenic. Placental abruption, uterine rupture, and preterm labor can occur following even minor trauma. In the event of acute cardiopulmonary arrest, maternal survival requires uterine-aortocaval decompression by perimortem cesarean section. All patients with a viable fetus should have continuous fetal monitoring for a minimum of 4 h following even minor trauma.

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Authors and Affiliations

  1. Department of Emergency Medicine, UT Health Science Center, MC7736, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Marcos Mavromaras M.D., Christina Bird D.O., Julie Gorchynski M.D. & Linda Hatch M.D.

Authors
  1. Marcos Mavromaras M.D.
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  2. Christina Bird D.O.
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  3. Julie Gorchynski M.D.
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  4. Linda Hatch M.D.
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Corresponding author

Correspondence to Christina Bird D.O. .

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Editors and Affiliations

  1. MedStar Georgetown University Hospital and MedStar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC, USA

    Joelle Borhart

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Mavromaras, M., Bird, C., Gorchynski, J., Hatch, L. (2017). Trauma in Pregnancy. In: Borhart, J. (eds) Emergency Department Management of Obstetric Complications. Springer, Cham. https://doi.org/10.1007/978-3-319-54410-6_11

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  • DOI: https://doi.org/10.1007/978-3-319-54410-6_11

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-54409-0

  • Online ISBN: 978-3-319-54410-6

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