Trauma in Pregnancy

Trauma is the leading nonobstetric cause of death during pregnancy, associated with up to 20% of maternal deaths in the United States and 10% of all such deaths worldwide. Traumatic injuries complicate up to 1 in 12 pregnancies. Unintentional trauma from motor vehicle crashes and falls accounts for most traumatic injuries in pregnancy, although 16% of traumatic injuries are caused by intentional violence, including suicide, gunshot wounds, and domestic violence. Even minor traumatic injuries are associated with an increased risk for adverse fetal and neonatal outcomes, including placental abruption, preterm labor, and fetal loss. The management of trauma in pregnancy is complex, and requires prompt recognition, an understanding of the physiologic changes in pregnancy, and a multidisciplinary approach. Prioritization of maternal resuscitation is critical to ensure optimal maternal and fetal outcomes.