Hill D A, Lense J J
Florida Hospital Family Practice Residency Program, Orlando, USA.
Am Fam Physician. 1996 Mar;53(4):1269-74.
Physicians who care for pregnant women must be prepared to evaluate and treat abdominal trauma during pregnancy. The evaluation and management of even minimal abdominal trauma in pregnancy is often problematic, and the use of laboratory tests, fetal monitoring, radiography and ultrasonography depends on the extent of the trauma and the viability of the fetus. Intervention ranges from reassurance to cardiopulmonary resuscitation and surgery. Common laboratory studies include a complete blood count, coagulation panel, urinalysis and blood type and screen. Ultrasonography is useful for evaluation of fetal weight and status of amniotic fluid, but tocodynamometry is more sensitive for diagnosis of placental abruption. Patients with minimal trauma and no bleeding, uterine contractions or abdominal pain can be safely discharged after four to six hours of monitoring, but patients with any of these findings should be admitted to the hospital for overnight observation with continuous fetal heart rate monitoring.
照顾孕妇的医生必须做好评估和治疗孕期腹部创伤的准备。即使是孕期轻微腹部创伤的评估和处理往往也存在问题，实验室检查、胎儿监测、放射照相术和超声检查的使用取决于创伤的程度和胎儿的存活能力。干预措施从安抚到心肺复苏及手术不等。常见的实验室检查包括全血细胞计数、凝血检查、尿液分析以及血型和筛查。超声检查有助于评估胎儿体重和羊水状况，但宫缩图对胎盘早剥的诊断更敏感。创伤轻微且无出血、子宫收缩或腹痛的患者在监测4至6小时后可安全出院，但有上述任何一项表现的患者应入院进行过夜观察，并持续监测胎儿心率。
