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Initial evaluation and management of pregnant women with major trauma

Sarah J Kilpatrick, MD, PhD
Section Editors
Charles J Lockwood, MD, MHCM
Scott Manaker, MD, PhD
Maria E Moreira, MD
Deputy Editor
Vanessa A Barss, MD, FACOG


Motor vehicle accidents and domestic/intimate partner violence account for most cases of maternal major trauma, while falls, burns, homicide, suicide, penetrating trauma, and toxic exposure account for the majority of the remainder [1-3]. Evaluation of the pregnant patient with major trauma presents unique challenges since the presence of a fetus means two patients are potentially at risk, both of whom require evaluation and management.

In the pregnant woman, compression of the abdomen from a fall, intentional violence, or a low-speed motor vehicle crash can be considered major trauma. Issues specific to the pregnant major trauma patient will be discussed here. Issues related to management of trauma in the nonpregnant population are reviewed separately. (See "Initial management of trauma in adults".)


A 2013 systematic review of studies on trauma in pregnancy reported the following estimates of trauma incidence/prevalence by subtype of trauma [3]:

Domestic violence: 8307/100,000 live births

Motor vehicle crash: 207/100,000 live births

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Literature review current through: Nov 2017. | This topic last updated: Sep 26, 2017.
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