Abdominal Trauma in Pregnancy



Background

All patients (trauma or medical) who are known to be pregnant are included in this management plan. The gestational age is irrelevant.

Pregnant women suffering trauma:

  • The rhesus status of the mother must be confirmed        Please check "Anti-D".
  • If the mother is rhesus negative, pregnant and suffers truncal trauma, she must be given rhesus Anti-D immunoglobulin.
  • Dose: 250 international units <20 weeks, 500 international units >20 weeks.
  • A Kleihauer's test must performed to estimate the volume of foetal leak.
  • Further follow-up is performed in the Obstetrics Dept.

If such a patient is discharged from the ED (which is unlikely) then, an obstetric out-patient appointment must be made.

The Obstetric Dept must be informed on all pregnant patients admitted to CUH.

In cases of penetrating injuries - treat the mother first, if stable refer to the Obstetric Registrar.


Blunt "minor" abdominal trauma

  • Blunt trauma - commonly seat-belt injury or assault.
  • Once mother is stable refer to the Obstetric Registrar.
  • Check FH, Kleihauer, exclude abruption and even if no marks on abdomen.
  • ALL cases (even apparently trivial trip or fall etc) of trauma in the third trimester must be referred to the antenatal ward for 4 hours of tochography.
  • Do NOT request an ultrasound scan as tochography is far more sensitive at excluding third trimester abruption.

Content by Dr Íomhar O' Sullivan 11/03/2004. Reviewed by Dr ÍOS 01/05/2005, 12/12/2005, 13/01/2007. Last review Dr ÍOS 30/08/14.