OB Trauma powerpoint

OB Trauma powerpoint - Blunt Trauma in the Pregnant Woman...

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Blunt Trauma in the Pregnant Woman Bill Schroeder DO Stanford Emergency Medicine
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Introduction Trauma occurs in 6-7% of pregnancies in US Leading nonobstetric cause of maternal death Female drivers are more likely to be in a MVA than male drivers: 84 vs 73 drivers per 10 million miles driven ACOG educational bulletin. Obstetric aspects of trauma management. Number 251, September 1998 (replaced Number 151, January 1991, and Number 161, November 1991). Int J Gynecol Obstet 1999;64:87-94
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Physiologic Changes in Pregnancy Grossman NB. Blunt trauma in pregnancy. Am Fam Physician. 2004 Oct 1;70(7):1303-10.
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Pregnant woman can lose 30% (2L) of blood volume before vital signs change At 30 wks GA the uterus is large enough to compress the great vessels causing up to a 30mm Hg drop in systolic BP 30% drop in stroke volume A series of 441 pregnant trauma victims with no detectable fetal heart tones showed no fetal survivors. •Grossman NB. Blunt trauma in pregnancy. Am Fam Physician. 2004 Oct 1;70(7):1303-10. •Morris JA Jr, et al. Infant Survival after Cesarean Section for Trauma. Ann Surg 1996;223:481-91.
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Seat Belts Nearly 20% of pregnant woman surveyed never or rarely used seat belts 22% used them incorrectly Proper placement of the lap belt is: As low as possible on the pregnancy bulge across the ASIS and pubic symphysis Placement on the uterus causes a 3-4x increase in force transmitted to the uterus Shoulder harness should be positioned between the breasts Pearlman MD, Phillips ME. Safety belt use during pregnancy. Obstet Gynecol 1996;88:1026-9
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ACOG recommendations “There is substantial evidence that seat belt use during pregnancy protects both the mother and the fetus” “Airbag deployment does not appear to be associated with increase risk for either maternal or fetal injury” Though based on limited data
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OB Trauma powerpoint - Blunt Trauma in the Pregnant Woman...

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