ABDOMINAL TRAUMA IN PREGNANCY


  • Need to be examined for uterine tenderness, ctx, FHT, vag exam for ROM, bleeding, cervical dilatation; Kleihauer-Bethke; NST if far enough along
  • Major risk is abruption
  • If pt complains of or is found to be contracting, need to try to r/o abruption: In addition to above, do u/s, CBC, fibrinogen, 24h fetal monitoring. n.b. nl fibrinogen >400; <300 is cause for concern. Tocolyze if contracting; use Mg; avoid terbutaline b/c makes it impossible to monitor HR as a sign of blood loss
  • Have pt watch for contractions, bleeding, or change in pain
  • If at > 20wks: