Although the pregnant patient's blood pressure falls during pregnancy, changes may not be as great as traditionally thought. Thus, tachycardia or hypotension in pregnant trauma patient should not be attributed solely to the gravid state. The uterus enlarges into the peritoneal cavity after the twelfth week of pregnancy, becoming more susceptible to injury while protecting other abdominal organs, such as the small bowel. The bladder also moves into the abdomen, and the ureters become dilated. There is decreased motility of the gastrointestinal tract.
Maternal death results most commonly from head injury.
Fetal movement Premature rupture of membranes Vaginal bleeding History of depression, substance abuse, or several emergency room visits should increase suspicion of battering. Interpersonal violence is not dependent on age, race, marital status, or socioeconomic class. Abdomen Inspect for ecchymoses, especially across the lower abdomen, which may indicate a possible seat belt injury. Palpate for uterine contractions or tenderness. Fetal heart tones can be assessed via Doppler or ultrasound.