Epidemiology of Trauma in Pregnancy

Purpose of the Review: Pregnant trauma patients are especially challenging given the necessity for evaluation and management of consequential maternal and fetal injuries. We have reviewed the literature and highlight the most common mechanisms of maternal trauma and fetal injury. Recent Findings: Trauma is the leading cause of non-obstetric maternal death. However, the fetus is disproportionately harmed in comparison to the mother in all reports of trauma in pregnancy: ranging from 3:1 to 9:1 fetal mortality: maternal mortality. Front airbags in pregnancy and three-point restraint systems reduce the injury to both the mother and the fetus. Injury from domestic violence has an increased prevalence in the pregnancy and also increased risk of low birth weight, preterm birth, and perinatal death. Opioid use in pregnancy has mirrored the general population, increasing each year. Up to 30% of maternal death is attributed to self-harm, with the highest rates of suicide occurring in the 1st trimester. Abruption accounts for 50–70% of fetal death following trauma and is more common among women with higher injury severity. Summary: Trauma is a significant contributor to maternal mortality as well as fetal mortality and requires a high degree of clinical suspicion. In this paper, we propose an ABCD simultaneous assessment of the fetus emphasizing a multidisciplinary approach to optimize survivability of both the mother and the fetus.