Associate Professor of Emergency Medicine, Vanderbilt University and Vanderbilt Children's Hospital, Nashville, TN.
Lee Physician Group, Fort Myers, FL.
Emerg Med Pract. 2020 Oct 15;22(Suppl 10):1-36.
This supplement reviews the evidence regarding important considerations in pregnant trauma patients, including the primary and secondary survey as well as the possibility for Rh exposure, placental abruption, uterine rupture, and the need for a prompt perimortem cesarean section in the moribund patient. Because ionizing radiation is a concern in pregnancy, the circumstances in which benefits of testing outweigh risks to the fetus are discussed. Emergency clinicians are encouraged to advocate for trauma prevention, including proper use of safety restraints in motor vehicles and screening for domestic violence, as these measures have been shown to be effective in reducing morbidity and mortality in this patient population. Recommendations for monitoring, admission, discharge, and follow-up are also provided.
本补充剂审查了关于创伤孕妇的重要考虑因素的证据，包括初级和次级调查以及 Rh 暴露、胎盘早剥、子宫破裂的可能性，以及在濒死患者中需要迅速进行剖宫产的可能性。由于电离辐射在怀孕期间是一个问题，因此讨论了测试的益处超过对胎儿风险的情况。鼓励急诊临床医生倡导预防创伤，包括在机动车辆中正确使用安全带和筛查家庭暴力，因为这些措施已被证明可有效降低该患者人群的发病率和死亡率。还提供了监测、入院、出院和随访的建议。
