[CG] Fall trauma to abdomen in pregnancy

Warning

exp date isn't null, but text field is

Please report any inaccuracies or issues with this guideline using our online form

History

  • Enquire re severity of trauma/mechanism of injury
  • Whether direct trauma to abdomen
  • Gestational age
  • Bleeding/ROM
  • Fetal movements
  • Pain/tightenings
  • If history of assault must be seen in hospital setting
  • Refer as appropriate if other injuries

Examination

Maternal observation includes:

  • Pulse/BP
  • Abdomen – abdominal exam for tenderness/contractions/bruising
  • Fetal heart auscultation

Investigations

  • CTG (if >26+0 weeks)
  • Kleihauer if trauma to abdomen after 19+6 weeks gestation + Rh Negative

Treatment

  • Anti-D if abdominal trauma and Rh Negative

  • If minor trauma/assessment normal – reassure and send home.

  • If more significant trauma (especially RTA/seatbelt injury), bleeding, tightenings, ROM, any concerns - Obstetric Middle Grade review/admit 24 hours.

  • If patient unstable/concern re mother or baby – admit to LW/inform obstetric staff urgently.

  • If history of non – sexual assault careful history and full examination must be recorded/obstetric review.

  • If additional sexual assault claimed inform police surgeon.

Last reviewed: 13 March 2014

Next review: 01 July 2021

Author(s): Mairi MacDermid

Co-Author(s): Sr. B Sutherland, Maternity Assessment, PRM; Dr F Mackenzie – Obstetric Consultant PRM on behalf of GONEC Group

Reviewer Name(s): Review 11.2013 – Version 2 Dr A.M. Mathers Consultant Obstetrician PRM on behalf of GONEC – no changes required