©Pregnancy bliss 2008
Results of trauma in pregnancy
Heavy blood loss resulting from pregnancy trauma
When there is severe haemorrhage as a result of an injury to any part of the body, the body does not classify the pregnant uterus as a vital organ.
If the pregnant woman is going into shock as a result of hemorrhage, blood will be diverted from the uterus to organs such as the heart, lungs and brain. If you think about it, this is logical. What is the point of ensuring fetal survival, if the mother is going to be killed in the process?
Prolonged shock from severe haemorrhage will almost inevitably lead to fetal loss.
Position for a bleeding pregnant woman who has sustained trauma
Place her on her left side and avoid putting her on her back. The left lateral position will allow adequate blood to continue flowing to the fetus. It will also prevent increased bleeding from injured lower limbs, a feature associated with a supine (lying on the back) position.
Role of cesarean sectionin pregnancy trauma
Caesarean section has a role to play but this will depend on a few factors.
As a rule, caesarean section will only be considered where fetal viability outside the womb is a realistic prospect.
Caesarean section will be considered in cases of:
· Fetal distress that cannot be relieved otherwise
· Penetrating injury to the uterus, putting maternal or fetal life at risk
· Some forms of spinal injury
· A need for extensive treatment to the mother in the abdominal area where the pregnant uterus may be in the way.
Fetal death and caesarean section
Fetal death resulting from trauma is not in itself an indication for caesarean section. The exception, which is quite uncommon, is where this measure is deemed an essential part of treatment for the injured mother.
Abdominal surgery in pregnancy and subsequent mode of delivery
If a woman, for whatever reason, undergoes abdominal surgery in the early phase of her pregnancy, it does not make subsequent caesarean delivery inevitable.
The mother may be anxious that her abdominal scar is still too fresh and therefore not strong enough to withstand the rigors of labor. This is not so and even a two week old scar can and will withstand labor.