Podcast #6: Trauma in Pregnancy/Perimortem C-section

Run Time: 15 minutesac07bd37-063f-4309-a0f3-5620b220935d

Author: Dr. Donald Stader

Educational Pearls:

  • Trauma ABCs change in pregnancy.
  • A: Progesterone dilates to blood vessels in the nose and the back of the throat changing the airway in pregnant women, causes intubation to be more difficult because of increased redundant tissue.
  • B: Pregnant women desaturate very quickly because of metabolic demands and diaphragm is pushed up. Supplemental oxygen should be used liberally.
  • C: Volume of fluids is increased during pregnancy. There is more blood flow to the uterus.
  • D: Starting in the 2nd trimester the uterus can push on the major blood vessels. Moving the uterus away from the Vena Ceva to the left will allow blood flow – either by left lateral decubitus or physically moving the uterus to the left.
  • E: Pregnant women need a complete head to toe exam and a manual vaginal exam.
  • Fibrinogen, rh, Kleihauer-betke tests are additional tests to consider adding to pregnant traumas.
  • The decision to perform a perimortem C-section should be made within 5 minutes of loss of pulses. Performing interestingly improves infant and mother’s chance of survival.

Link to Podcast:  http://medicalminute.madewithopinion.com/trauma-in-pregnancy-perimortem-c-section/

References:  http://www.aafp.org/afp/2014/1115/p717.html

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