Always administer continuous oxygen. The fetus may be shocked even when the mother appears haemodynamically stable. To determine whether PV bleeding is fetal or maternal an APPT test may be performed by biochemistry. When spinal injuries are not suspected, the injured patient should be transported and evaluated lying on the left lateral side. If spinal injuries are suspected, then the right hip should be elevated on a sandbag and the uterus manually moved to the left so that it is not resting on the inferior vena cava.
Pregnant women are prone to gastric reflux due to the height of the uterus.
A naso-gastric tube should be considered to prevent aspiration of gastric contents. Amniotic fluid emboli or extensive placental separation which may cause DIC Pelvic fracture with massive retroperitoneal bleeding due to engorged pelvic vessels. Tearing of broad ligaments results in massive haemorrhage and rapid fetal death. Peritoneal lavage via a supra umbilical incision is performed for the same indications as for a non-pregnant patient. If abdominal surgery is required, it is performed through a midline incision.