Trauma in pregnancy: Difference between revisions
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*Viable = >20-24wk (~fundus above umbilicus) | *Viable = >20-24wk (~fundus above umbilicus) | ||
*nl FHR = 120-160 beats/min | *nl FHR = 120-160 beats/min | ||
*For maternal vitals see [[ | *For maternal vitals see [[Maternal Vitals and Labs in Pregnancy]] | ||
==Diagnosis (Abruption)== | ==Diagnosis (Abruption)== | ||
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==See Also== | ==See Also== | ||
[[Fetal Maternal Hemorrhage (RhoGAM)]] | *[[Fetal Maternal Hemorrhage (RhoGAM)]] | ||
*[[Perimortum C-Section]] | |||
[[Perimortum C-Section]] | *[[Abruption]] | ||
*[[Maternal Vitals and Labs in Pregnancy]] | |||
[[Abruption]] | |||
[[Vitals]] | |||
==Source== | ==Source== | ||
Revision as of 21:23, 30 October 2011
Background
- Concern for trauma and abruption
- Viable = >20-24wk (~fundus above umbilicus)
- nl FHR = 120-160 beats/min
- For maternal vitals see Maternal Vitals and Labs in Pregnancy
Diagnosis (Abruption)
Symptoms
- Vag bleed
- Cramps/contractions
- Uterine tenderness
- Hypovolemia
- Abnl fetal HR
US only 50% acurate
Treatment & Disposition
- Nonviable fetus (<20-24wks)
- Standard treatment for trauma
- Consider RhoGAM
- Viable fetus (>20-24wks)
- Consider RhoGAM
- Monitor (fetal) all for 4-6hrs -->
- Extend Monitoring to 24hrs, if risk factor or abnormal 6hr monitoring
Risk Factors (ATLS)
- Maternal heart rate > 100
- Injury Severity Score > 9
- Evidence of placental abruption
- Fetal heart rate > 160 or <120
- Ejection during a motor vehicle crash
- Motorcycle or pedestrian collisions
Abnormal Monitoring
- >3 contractions/hr
- Persistant uterine TTP
- Worisome strip
- Vag bleed
- PROM
- Serious maternal injury
Partial abrution w/ stable mom/fetus and <32wk may have expectant care (with easy access to emergent C-section)
Abrupion = risk DIC
See Also
- Fetal Maternal Hemorrhage (RhoGAM)
- Perimortum C-Section
- Abruption
- Maternal Vitals and Labs in Pregnancy
Source
3/29/06 DONALDSON (adapted from Rosen)