Trauma Management in Pregnant Patients

Trauma remains a leading non-obstetric cause of maternal and foetal morbidity and mortality worldwide. Management begins with the standard primary survey—airway, breathing, circulation, disability and exposure—adapted to account for the cardiovascular and anatomical changes of pregnancy. Maternal stabilisation is paramount, as foetal well-being depends directly on maternal perfusion. Early multidisciplinary involvement—including obstetrics, anaesthesia, surgery and neonatology—ensures coordinated care. Imaging strategies balance diagnostic yield with minimising radiation exposure: focused ultrasonography guides rapid assessment, while computed tomography is employed when indicated. Continuous foetal monitoring is instituted once viability is reached, and decision-making regarding perimortem caesarean delivery is guided by gestational age and maternal status. Prevention strategies, notably correct use of restraints and public education, complement acute management. Hemorrhage control, airway protection and prevention of secondary insults form the cornerstones of care, supported by blood-product protocols and critical-care resources. Despite diverse global settings, the guiding principle remains: prioritise maternal survival to optimise foetal outcome.

Research from Nature Portfolio

Recent studies have demonstrated that targeted education significantly improves correct seatbelt use among pregnant drivers. A large cross-sectional survey revealed that receiving guidance early in pregnancy doubled the odds of proper lap-and-shoulder belt positioning under the abdomen and over the iliac crests. Gestational age was also an independent predictor of adherence, suggesting that interventions should be timed to early trimesters. These findings underscore the importance of integrating restraint counselling into routine antenatal care and highlight a direct, modifiable factor in reducing crash-related maternal and foetal injury.

Trauma Management in Pregnant Patients publication trend

The graph below shows the total number of articles in trauma management in pregnant patients across all publications each year (not limited to Nature Index journals).

Technical terms

Focused assessment with sonography in trauma (FAST): A rapid bedside ultrasound examination of the abdomen and thorax to detect free fluid or organ injury in trauma patients.

Computed tomography (CT): A cross-sectional imaging modality used in trauma to identify internal injuries, including haemorrhage and visceral damage.

Finite element model: A computer simulation technique that divides complex structures into small elements to predict mechanical responses under variable conditions, such as vehicle collisions.

Placental abruption: Premature separation of the placenta from the uterine wall, which can compromise maternal haemodynamics and foetal oxygenation during trauma.

References

1. Assessing seatbelt use among pregnant drivers in Australia: Correct seatbelt positioning, discomfort, knowledge and information sources. Journal of Safety Research (2025).
2. Initial Imaging of Pregnant Patients in the Trauma Bay—Discussion and Review of Presentations at a Level-1 Trauma Centre. Diagnostics (2024).
3. Prediction of Placental Abruption of Pregnant Women Drivers with Various Collision Velocities, Seatbelt Positions and Placental Positions—Analysis with Novel Pregnant Occupant Model. International Journal of Environmental Research and Public Health (2024).
4. Education for appropriate seatbelt use required for early-phase pregnant women drivers. Scientific Reports (2020).