Mass casualties and the obstetrical patient

Mass casualties can result from natural events such as earthquakes, tsunamis, or floods, or from intentional acts of terrorism. The effects of mass casualties on pregnancy outcomes are largely derived from observational and descriptive studies. Pregnant women seem to be more susceptible to the psychological effects of a mass casualty experience, and the severity of exposure is predictive of the degree of behavioral health effects. A variety of ethical issues arise in domestic or international disaster management. International disaster relief planning echoes similar concerns noted in domestic events, and shares the deficiencies noted in domestic planning with respect to care of obstetric patients. Depending upon the geographic location of an event, access to and care of patients may be hampered by poor infrastructure. Obstetric disaster management planning would benefit from the thoughtful and early involvement of obstetrician-gynecologists.