Trauma during pregnancy: a situation pregnant with danger

Trauma in pregnancy is currently a leading cause of non-pregnancy-related maternal death, and maternal death remains the most common cause of fetal demise. The most common etiologies of trauma in pregnancy include transportation accidents, falls, violent assaults, and burn injuries. Head and neck injuries and hemorrhagic 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 health care team. Expeditious maternal resuscitation is the most effective method of fetal resuscitation. The management of pregnant trauma victims requires the anesthesiologist, 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.