Trauma is a frequent cause of maternal death. The major causes of maternal injury are vehicular accidents, falls, and penetrating objects. Generally, there are few differences in the treatment of the pregnant trauma victim versus that of the non-pregnant victim. The divergence of treatment premise in the pregnant patient can be accounted for by the major physiologic changes that occur during pregnancy. Seatbelts protect the mother from death, thereby protecting the fetus.
Maternal death is the leading cause of fetal death in trauma.
Bleeding may exceed four liters and be manifest as refractory hypovolemic shock. Recent pelvic fracture does not necessarily preclude vaginal delivery. The gravid uterus has been shown to be protective to intra-abdominal organs. The uterus is protected until the 12th week by the bony pelvis, at which time it becomes an abdominal organ. The uterus is a highly resilient organ and can withstand pressures up to 10 times that of normal labor.