Trauma in Pregnancy-Requiring Intensive Care

Trauma to the parturient is uniquely challenging because of the physiological changes that could happen during pregnancy, as well as the fact that two lives, rather than one, are in danger. Trauma during pregnancy ranges in severity; it can be as minor as a simple bump, or as severe as a gunshot. Even minor trauma during pregnancy may result in fetal loss. The commonest causes of trauma during pregnancy are domestic abuse and road traffic accidents. Appropriate assessment and timely management of pregnant trauma patients are crucial to avoid maternal and fetal complications. The approach to pregnant trauma patients is similar to non-pregnant trauma patients, which includes the primary survey, secondary survey, and use of adjunct diagnostic tests. Assessment of the fetus and fetal monitoring is essential in any pregnant patient with trauma. This chapter offers an overview of trauma management during pregnancy, including the initial management as per Advanced Trauma Life Support (ATLS) protocols and the management in the intensive care unit.