Assessment and initial management of the pregnant trauma patient

The pregnant trauma patient with a blunt or penetrating injury presents a unique and challenging clinical situation. Two patients must be treated simultaneously: the mother and fetus. The author reviews the assessment changes of pregnancy, which can both mask and mimic injury. The unique injuries that occur in this patient population are described, including abruptio placentae, preterm labor, fetomaternal hemorrhage, and uterine and fetal trauma. Successful resuscitation of the pregnant trauma patient requires early and frequent collaboration with the obstetrical staff. Within a team approach, the dual assessment of mother and fetus can render prompt identification and treatment of injuries. Diagnostic tests, including laboratory data, radiographic exams, and abdominal and obstetrical procedures, are reviewed.