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.