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accidents in pregnancy, domestic violence, health care practitioners, nonobstetrical causes of maternal morbidity and mortality, obstetric emergencies, trauma in pregnancy



  1. Colburn, Vicki RN, BSN, MED, QMC


Of all cases that come to hospital emergency rooms, the traumatized pregnant patient presents one of the most complicated dilemmas because nurses and doctors who commonly treat trauma victims rarely have comparable expertise in the management of pregnancy. Treatment and care of the traumatized pregnant patient are challenging because advanced pregnancy influences the pattern of trauma, alters laboratory values and clinical assessments, and changes hemodynamic parameters. Pregnancy may alter the usual trauma routines, and trauma may affect the outcome of the pregnancy. It is imperative that both the trauma team and perinatal team work collaboratively toward a common goal of resuscitating and stabilizing the pregnant woman without jeopardizing the fetus whenever possible. This article reviews alterations in anatomy and physiology that occur during pregnancy and discusses the impact of decision making by health care practitioners faced with the dilemma of managing trauma during pregnancy.