Abdominal Trauma in Pregnancy


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 26/05/21.