Blunt Trauma in Pregnancy AUTOMOBILE ACCIDENTS Trauma affects 6-7% of pregnancies in the U.S. 60 - 67% related to automobile accidents. Fetal mortality after maternal blunt trauma is 34 - 38%. The two major causes of fetal death after maternal blunt trauma are: Maternal shock/death, and placental abruption. The pregnant trauma patient presents a unique challenge because care must be provided for two patients, the mother and the fetus. It is vital that the nurse know and understand the anatomical and physiological changes that occur during pregnancy. She must be aware of these changes, and how they can mask or mimic injury, and very importantly that fetal distress or loss can occur even when the mother has incurred no abdominal injuries. Regardless of the apparent severity of injury in blunt trauma, all pregnant women should be evaluated in a medical setting. Only viable fetuses are monitored, because no obstetric intervention will alter the outcome of a pre-viable fetus. Determination of fetal viability is subject to institutional variation: an estimated gestational age of 20 - 26 weeks and an estimated fetal weight of 500g. Are commonly used thresholds of viability. Therefore, patients who have minor trauma and who are at less than 20 weeks gestation do not require specific intervention or monitoring. All pregnant women beyond 20 weeks’ gestation should undergo a minimum of 4 - 24 hours, and in some cases as long as 48 hours of monitoring. Fetal distress may be the first sign of maternal hemodynamic compromise and fetal distress, and to identify possible placenta abruption. Resuscitation of the more serious trauma patient must focus on the mother because the most common cause of fetal death is maternal shock or death. It is important to remember that the mother will maintain her vital signs at the expense of the fetus. Because plasma volume is increased by 50% and the mother is able to shunt blood away from the uterus, maternal shock may not manifest itself until maternal blood loss exceeds 30%. Initial ABC assessment: Airway and breathing: All pregnant trauma patients should receive supplemental oxygen, because the fetus is extremely sensitive to hypoxia and because the oxygen reserve is significantly diminished in the pregnant patient. Because the heavy uterus may compress the great vessels when a pregnant women is supine, causing a decrease... ... middle of paper ... ...revention is key to increasing maternal and fetal survival. Although motor vehicle crashes are responsible for most severe maternal injuries and fetal losses form trauma, pregnant women have low rates of seat belt use. Proper seat belt use is the most significant modifiable factor in decreasing maternal and fetal injury and mortality after motor vehicle crashes. Seat belt-restrained women who are in motor vehicle crashes have the same fetal mortality rate as women who are not in motor vehicle crashes, but unrestrained women who are in crashes are 2.8 times more likely to lose their fetuses. Prenatal care must include three-point seat belt instruction. The lap belt should be placed under the gravid abdomen, snugly over the thighs, with the shoulder harness off to the side of the uterus, between the breasts and over the midline of the clavicle. Seat belts placed directly over the uterus can cause fetal injury, pregnant patients should be instructed to seek care immediately after any blunt trauma.. REFERENCES: Introduction to Maternity & Pediatric Nursing, Fourth Edition; Gloria Leifer, MA, Copyright 2003, Elsevier Science (USA). http://www.aafp.org http://www.med.umich.edu
Hockenberry, M. J., & Wilson, D. (2013). Wong’s nursing care of infants and children + study guide: Multimedia enhanced version. Philadelphia, PA, United States: Elsevier Mosby.
Miehl, N. (2005). Shaken baby syndrome. Journal of Forensic Nursing 1(3), 111-117. Retrieved from http://web.a.ebscohost.com.ezproxy.parkland.edu:2048/ehost/pdfviewer/pdfviewer?vid=6&sid=5afd0ec9-9244-4874-888f-58b9a8746292%40sessionmgr4004&hid=4214
When fetal death occur after 20 weeks its called stillbirth. Unfortunately, in just under a third of cases doctors cannot tell them why their baby died. If doctors aren’t sure what caused a baby’s death it can be discovered by investigation. Not all women agree to the test from the guilt of drinking alcohol during their pregnancy. Certain factors do increase your risk of having stillborn baby alcohol consumption is a main factor. A mother who consumed alcohol during pregnancy is 40% more likely to experience a 70 % elevated risk of stillbirth compared with
In my previous role as a Licensed vocational nurse, I worked in the outpatient setting, Perinatology, where there are high-risk pregnant patients. The patient I helped take care of, was early in her pregnancy, approximately 29 weeks, and was a patient who had been seen in this clinical office
Twenty five to thirty percent of babies shaken die (National Shaken Baby Syndrome). Immediate medical attention can help reduce the impact of shaking, but many children are left with permanent damage from the shaking. The treatment of survivors falls into 3 major categories. Those categories are medical, behavioral, and educational. In addition to medical care, children may need speech and language therapy, vision therapy, physical therapy, occupational therapy, and special education services. (Showers, 1997) Many incidents of Shaken Baby Syndrome are not reported out of fear. It is important to seek immediate and early medical attention. Serious complications and even death can be avoided.
the case of rape, incest, known deformity, or grave danger to the life of the mother.” Dr.
In this case, the onset of sepsis was detected speedily with the Midwife acting on her instincts thus promptly informing key members of the multidisciplinary team. Sepsis may be insidious in onset however it may also rapidly progress misleading health care workers of its severity, which is evident in the latest CMACE report. Returning “back to the basics” is key in the early detection and treatment of sepsis and is an essential factor to decreasing the direct cause of maternal mortality hence midwives must remain vigilant to signs and symptoms of infection. There is clearly a need to raise both maternal and professional awareness about sepsis so that it can be prevented, where possible, and finally lead to a decrease in the direct cause of maternal death.
People always think that nothing bad would ever happen to them, or that they would never make the same mistakes as other mothers. The fact of the matter is it can happen to anyone and it will happen if people are not careful. 21 % of women use illegal drugs and alcohol during the nine months of pregnancy. Whether it is just one drink or one hit or this is an everyday occurrence; it can affect the baby mentally and physically for the rest of its life.
People place their trust in their doctors and hospitals. They rarely expect that the anticipation of a brand new life will lead to serious complications due to a birth trauma. The fact that the trauma of birth is serious and might lead to medical complications or even the death of the new born baby. This is a very heart wrenching time and the family is upset and do not know what step to take. Well, the birth injury might be due to the negligence of the medical facility, doctor, or hospital staff. Therefore, it is important to seek the services of a birth injury lawyer to represent the family in court.
Healthy people 2020 states “The risk of maternal and infant mortality and pregnancy-related complications can be reduced by increasing access to quality preconception (before pregnancy) and interconception (between pregnancies) care. Moreover, healthy birth outcomes and early identification and treatment of health conditions among infants can prevent death or disability and enable children to reach their full potential.” (CITE HEALTHY PEOPLE) Objective maternal, infant, and child health (MICH)1.1 has the goal of “reducing the rate of fetal deaths of fetuses at 20 or greater weeks gestation”. (C...
A neonatologist has many tasks and responsibilities before, during, and after the birth of an at-risk newborn. If there is reason to believe there are going to be complications with a birth that would cause negative side effects for the infant, a neonatologist will be brought in to help. In these high-risk situations, a team effort is required and the neonatologist takes the lead position. The neonatologist will be responsible for advising the parents on what to expect during and after labor. After the infant is born, the neonatologist has to find a method to properly care for the baby. Because most premature babies have a low birth-weight, their lungs need to be supported and they need to be kept warm. During this whole process, the neonatologist interacts with the parents to keep them updated on their baby’s condition (Weaver, 2009).
Birth injuries vary in severity from minor injury – such as cuts and bruises – to death.
Ward, S. L., & Hisley, S. M. (2009). Maternal-Child Nursing Care: Optimizing Outcomes for Mothers, Children, and Families. Philadelphia, PA: F.A. Davis.
Stillbirth, also called intrauterine fetal demise, is the loss of a baby after 20 weeks of pregnancy and before or during delivery. A stillborn baby does not show any signs of life, such as a heartbeat or breathing. Usually, there is nothing that can be done to prevent stillbirth.
Preterm birth is defined as ‘any neonate whose birth occurs before the thirty seventh week of gestation’1 and represents approximately eight percent of all pregnancies1-4. It is eminent that these preterm infants are at risk of physical and neurological delay, with prolonged hospitalisation and an increased risk of long-term morbidity evident in prior literature3, 5-13. Innovative healthcare over the past thirty years has reduced mortality significantly14, with the survival rate of preterm infants having increased from twenty five percent in 1980 to seventy three percent in 200715. Despite, this drop in mortality long-term morbidity continues to remain within these surviving infants sparking a cause for concern15, 16.