A situation pregnant with danger: Trauma in pregnancy

Abstract

Trauma in pregnancy is currently a leading cause of non-pregnancy-related maternal death, and maternal death remains the most common cause of foetal demise. The most common aetiologies of trauma in pregnancy include transportation accidents, falls, violent assaults and burn injuries. Head and neck injuries and haemorrhagic shock account for most maternal deaths secondary to trauma. Women of childbearing age are among the population at greatest risk for trauma. The pregnant trauma victim presents a unique spectrum of challenges to the healthcare team. Expeditious maternal resuscitation is the most effective method of foetal resuscitation. The management of pregnant trauma victims requires the anaesthesiologist, the obstetrician and the trauma surgeon to consider and understand the unique changes in anatomy and physiology that take place during pregnancy. This article reviews the current considerations for the optimal perioperative management of pregnant trauma victims.