Anatomical changes in the third trimester of pregnancy. Illustration by Anne Rains.
By Sylvia Foley, AJN senior editor
In this month’s CE feature on Trauma in Pregnancy, author Laura M. Criddle takes a calm look at a distressing subject. After outlining possible mechanisms of injury, Criddle reminds readers that “trauma care priorities don’t change when the patient is pregnant.” Initial interventions will still focus on the “ABCs”—airway, breathing, and circulation. She also points out that the fetus’s best chance for survival is “vigorous resuscitation of the mother,” since most fetuses will not survive maternal death.
However, the normal changes of pregnancy can affect both the nature of injury and the body’s responses; this has important implications for nursing care. Among Criddle’s key points:
- Compression and displacement of various organs occur as pregnancy advances. This makes some injuries more likely, others harder to detect.
- The normal changes of pregnancy can mask the signs of decompensation.
- Pregnancy and its changes can also make complications after injury more likely.
Criddle provides several examples for each point. She also offers strategies for assessment and interventions for both mother and fetus.
Have you cared for pregnant trauma patients? What was the experience like? Please tell us in the comments.
Correction on the spelling of warrant!
I cared for a woman who was 39 weeks pregnant and was involved in a MVA where there was a death in the other car. Because of the magnitude of trauma on the other car, there was a significant mechanism of injury present to warrent keeping her for fetal heart monitoring and to monitor her as well.
Turns out she had a partial abruption and needed an emergency c-section a few hours later.