Journal of Universal Surgery

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Trauma during Pregnancy �?¢�?�?��?�?? a Real Challenge

Chhabra S and Mahakalkar Y

Introduction: Pregnancy increases risk of trauma, due to physiological changes. Major determinant of obstetrical outcome are severity of injury, gestation. Recent systemic review reveals limitation of literature. Objectives: Present review is to look at whys, what’s of trauma, action needed. Material and Methods: Literature was searched with help of various search engines. Results: Although precise incidence is not known, trauma complicates 1 of 12 pregnancies, leading non-obstetric cause of maternal deaths, 8 % non-obstetric deaths in pregnant women in some countries. Most common causes include vehicle accidents, domestic/intimate partner violence, burns, homicide, and suicide. Penetrating trauma, toxic exposure account for majority of remainder. Risk increases in women who work outside, especially industries, while walking on slippery floor, hurrying, carrying heavy objects. There is increased risk of motor vehicle crash (MVC) in second trimester. While choosing diagnostic modalities, concern about radiation exposure to fetus is valid, but delayed/missed diagnosis has greater risk than diagnostic hazards. Plain x-ray, digital radiography, fluoroscopy, angiography, Computerized Tomography (CT), do cause ionizing radiation but effects depend on number, location, exposure. Placental abruption, feto-maternal hemorrhage, preterm labor, pre-labour rupture of membrane, cord prolapse, hemorrhage, visible/hidden neurological effects, infection, organ dysfunction, effects of medication, stress, fear are real dangers for mother/baby. Management is unique challenge because two patients mother/fetus are potentially at risk with major anatomic, physiologic differences. Requires multidisciplinary approach, emergency clinician, trauma surgeon, obstetrician, and neonatologist. Conclusion: Trauma during pregnancy is dangerous. Quick appropriate diagnosis, treatment with multidisciplinary approach is essential.