Care of the Pregnant Trauma Patient

This is a unique question-and-answer chapter for surgical residents and trainees, concentrating on the care of pregnant trauma patient. Cardiotocographic monitoring (CTM) records both uterine contractions and fetal heart rate, and is one of the mainstays of detecting problems with the fetus or premature labor. A period of monitoring should be considered for every pregnant patient suffering blunt abdominal trauma. The care of the traumatic brain injured pregnant patient should focus on reducing intracranial pressure and replacing maternal hormones depleted due to hypothalamic and pituitary dysfunction. CTM for a minimum of 24 hours of CTM is recommended for patients with frequent uterine activity, abdominal or uterine tenderness, vaginal bleeding, or hypotension as these are possible signs of placental abruption. Nutritional support, seizure control, and avoidance of infections and thrombotic complications are required in the care of the pregnant patient with a traumatic brain injury to ensure normal growth and development of the fetus.