Results:
Upon assessment of pregnant women involved in trauma, one of the first
steps is to assess trauma severity as determined by mechanism of injury,
and signs and symptoms revealed by history taking, physical examination,
and laboratory tests22. This is performed in order to
triage women into high or low risk and hence determine their management
and observation period23. Nevertheless, even minor
trauma during pregnancy, which is the more common, may be associated
with adverse outcomes. Several predictive factors for adverse maternal
and fetal/neonatal outcomes have emerged over the years, these may
include advanced maternal age and advanced gestational age
(>35 weeks), primiparity and high-risk pregnancy, MVA
characteristics such as ejection from the vehicle, pedestrian or
motorcycle injury, lack of seatbelt use, and lastly, injury
characteristics such as abdominal and pelvic injury, intracranial
injury, internal organ injury, open injury, and loss of
consciousness23.
Transplacental passage of fetal blood into the maternal circulation is a
common phenomenon, occurring in up to 98% of all
pregnancies24. However, massive FMH is a rare
condition during pregnancy. Possible causes include procedures of
prenatal diagnosis, vaginal bleeding due to placental abnormalities
(placenta previa or placental abruption), external cephalic version and
maternal trauma 25.