[Trauma and pregnancy].

The medical care provided to a pregnant trauma patient by a trauma specialist should be supplemented by a careful evaluation of the pregnant woman by an obstetrician. Motor vehicle accidents account for two-thirds of all trauma events during pregnancy, and both blunt abdominal trauma and trauma to the skull are associated with high mortality of the fetus. The severity of the trauma is an important prognostic factor for survival of both mother and fetus. Fetal injury can be caused even by apparently mild forms of maternal trauma. For early diagnosis of an abruptio placentae after blunt trauma to the abdomen, continuous monitoring of the fetal heart rate and uterine contractions is very useful. Monitoring should be continued for at least 4 h, and whenever the frequency of uterine contractions exceeds one per 15 min or tenderness of the abdomen or vaginal bleeding is present, the pregnant trauma patient should be carefully monitored under hospital conditions for at least 24 h. Extensive burns are rarely encountered during pregnancy. There is a direct correlation between the extent of the burns and survival of the fetus. When more 30% of the maternal body surface is affected by burns, fetal mortality exceeds 50%. In the third trimester, when survival chances of the fetus are better than 50%, premature delivery of the fetus should be considered whenever the mother has suffered extensive burns.