[CG] Fall trauma to abdomen in pregnancy

• 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

Maternal observation includes:

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

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

• 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.