Midwifery, the role in obstetric Trauma

Session

Medical, Dental and Pharmaceutical Sciences

Description

Trauma care of the parturient involves evaluation and resuscitation of two individuals (mother and fetus) and occasionally perimortem cesarean section to promote fetal survival despite mortal wounding of the mother. The primary principle in management of the traumatized parturient is prompt and sustained resuscitation of the mother, thereby providing the best opportunity for a favorable outcome for both the mother and the fetus. Maternal mortality from trauma during pregnancy is not significantly greater than that of the non-pregnant population; however, resuscitation is more complex. Furthermore, significant fetal vulnerability exists, with fetal death exceeding maternal mortality by three- to nine-fold. The chief mechanisms of trauma during pregnancy include motor vehicle accidents (approximately two-thirds of cases), falls, assaults, suicide, and burn injury. The leading risk factors for fetal mortality include:

  • (i) maternal death,
  • (ii) overall maternal injury severity,
  • (iii) presence of severe abdominal injury, and
  • (iv) the presence of hemorrhagic shock.
  • In high-speed accidents, the protuberant abdomen of a pregnant woman is prone to injury, with increased risk to the uterus and fetus after 20 weeks of pregnancy, as the uterus emerges out of the protective pelvis. Seat belt restraints have significantly improved both maternal and fetal outcomes. However, the lack of information regarding proper seatbelt use and its correct placement continues to be a problem contributing to injury. Pregnant women should wear a three-point restraint during automobile travel, and the lower portion of the seatbelt should be across the lap and not over the dome of the uterus.

Keywords:

Midwifery, Obstetric trauma

Session Chair

Xhevat Pllana

Session Co-Chair

Dafina Gexha Bunjaku

Proceedings Editor

Edmond Hajrizi

ISBN

978-9951-437-69-1

Location

Pristina, Kosovo

Start Date

27-10-2018 1:30 PM

End Date

27-10-2018 3:00 PM

DOI

10.33107/ubt-ic.2018.369

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Oct 27th, 1:30 PM Oct 27th, 3:00 PM

Midwifery, the role in obstetric Trauma

Pristina, Kosovo

Trauma care of the parturient involves evaluation and resuscitation of two individuals (mother and fetus) and occasionally perimortem cesarean section to promote fetal survival despite mortal wounding of the mother. The primary principle in management of the traumatized parturient is prompt and sustained resuscitation of the mother, thereby providing the best opportunity for a favorable outcome for both the mother and the fetus. Maternal mortality from trauma during pregnancy is not significantly greater than that of the non-pregnant population; however, resuscitation is more complex. Furthermore, significant fetal vulnerability exists, with fetal death exceeding maternal mortality by three- to nine-fold. The chief mechanisms of trauma during pregnancy include motor vehicle accidents (approximately two-thirds of cases), falls, assaults, suicide, and burn injury. The leading risk factors for fetal mortality include:

  • (i) maternal death,
  • (ii) overall maternal injury severity,
  • (iii) presence of severe abdominal injury, and
  • (iv) the presence of hemorrhagic shock.
  • In high-speed accidents, the protuberant abdomen of a pregnant woman is prone to injury, with increased risk to the uterus and fetus after 20 weeks of pregnancy, as the uterus emerges out of the protective pelvis. Seat belt restraints have significantly improved both maternal and fetal outcomes. However, the lack of information regarding proper seatbelt use and its correct placement continues to be a problem contributing to injury. Pregnant women should wear a three-point restraint during automobile travel, and the lower portion of the seatbelt should be across the lap and not over the dome of the uterus.