Trauma In Pregnancy

Section 7 - PEDIATRIC / OBSTETRICAL

Check for uterine contractions, vaginal bleeding and / or leaking amniotic fluid. Assess for fetal movements.
Raise right side of backboard approximately 30 degrees.
If hypotension / shock present, refer to SHOCK PRACTICE PARAMETER (5.13).
If patient in labor refer to the EMERGENCY CHILDBIRTH PRACTICE PARAMETERS (7.06).

Maternal health and well being should not be compromised to save a fetus of any gestational age.
Emergency C-Section should only be considered when maternal death has verified and is determined to be irreversible
- Trauma that cannot support life accompanied by a rhythm that cannot support life.
- Trauma with ASYSTOLE (4.02) or No vitals with ASYSTOLE (4.02)
- “Injuries and rhythm that is inconsistent with life.”
Fetus viability- 24 weeks gestational age or greater.
For optimal survival C-Section should be performed within 4 minutes of maternal death
Assess fetal heart tones if possible
Prepare Equipment- OB kit, trauma pads, and infant resuscitation equipment.
Locate anatomical landmarks for incision-Xiphoid Process and Pubis
Using a scalpel, perform vertical incision midline between-Xiphoid Process and Pubis
- Cut through each layer of the abdominal wall with the scalpel and/or scissors.
- Lift skin and pull apart working through the layers
- Using the scalpel make initial incision in the uterus.
- Using scissors cut the uterine wall.
- Remove neonate,
- Suction the neonate’s airway.
- Double clamp the cord
- Keep the infant lower than the mother.
- Wait for the cord to stop pulsating,
- Record APGAR at 1 and 5 minutes.
- Transport to the appropriate facility.