Trauma in pregnancy

Sadly, trauma is a fact of life for the pregnant woman as much as for others. This may be in the form of a physical assault, a motor traffic accident, a domestic accident or an accident at work.

When a pregnant woman is injured, especially if it is somewhere around the abdomen or pelvis, the ensuing anxiety becomes two-pronged. "Am I alright and is my baby alright?" This concern is readily understandable and explainable. The natural maternal instinct is for the preservation of her child.

It is true that nature makes pregnancies fairly safe from considerable trauma, even when this is directly inflicted on the abdomen or pelvis.

Miscarriage or premature labour are not common consequences, even of major trauma. However, there may be other less serious consequences of trauma that may call for specific actions.

Causes of Trauma in Pregnancy

Among women of childbearing age (16-45 years), trauma is a leading cause of hospitalization and occupies one of the three top spots in causes of death among people of this age group throughout the Western world. Pregnant women are included in these statistics.

Violent assaults - usually from another member of the family - and road traffic accidents are the leading causes of trauma in pregnancy. There are also accidental injuries, sustained at home or in the workplace. Falls are relatively common.

Fetal loss or premature labour resulting from trauma

There are no reliable figures anywhere quantifying fetal loss as a direct result of trauma.

At an individual level, outcome of trauma sustained by a pregnant woman depends on several independent factors. These will include the area of injury, the severity of the injury, the gestational age and, not least, the psychological fallout, especially if it was a case of assault.

Site of injury in pregnancy

For obvious reasons, the farther the injury is from the abdomen, the better the prospects for the pregnancy. If the injury is completely away from the pregnant uterus, then the prognosis for the pregnancy is, by and large, good.

A direct penetrating trauma to the uterus reduces the prospects for the fetus quite substantially.

However, it is not always so clear-cut. A remote injury could be so severe that part of the treatment could involve the sacrifice of the pregnancy. This is rare.

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Pregnant women in the Middle East are not immune to the violence that blight the region