Although clotting studies remain normal, levels of coagulation factors and fibrinogen increase. Back to Index. The well-being of the baby is entirely dependent on the welfare of the mother. Attention must therefore be directed immediately to the ABC stabilization of the pregnant victim. Good oxygenation and provision of adequate circulatory volume are critical.
Maternal shock is fatal to the fetus in most cases.
Because hypotension and tachycardia do not occur in the pregnant patient until blood loss is extensive, begin a rapid IV infusion on every patient. If the secondary survey shows no evidence of blood loss, slow the infusion after 1-2 liters have been given. Once the mother is stable, evaluate the uterus and fetus during the abdominal exam of the secondary survey. The exam includes the presence of fetal motion, the firmness of the uterus and presence of contractions, the presence of uterine tenderness, vaginal bleeding, and the fetal heart tones. Test the vaginal fluid with nitrazine paper to screen for amniotic fluid.