Key Content

Trauma accounts for 10% of annual worldwide deaths, and 6–8% of all pregnancies will experience some form of trauma. Pregnancy is an independent predictor for mortality.

Trauma services in the UK were reorganised in 2012. Since then, the odds of survival from major trauma have increased by 19% compared with 2008.

Trauma has maternal complications (for example, haemorrhage, abruption and disseminated intravascular coagulation) and fetal complications (such as preterm birth, hypoxic brain injury and death).

Clinicians should initiate aggressive fluid resuscitation and strongly consider the possibility of concealed blood loss. Emphasis should be placed on warmed blood products and tranexamic acid.

Trauma imaging should not be delayed for fear of risk to the fetus; we must continue to reinforce the tenet that the mother’s health takes priority over the fetus in all decision making and the mother’s condition should be stable prior to the assessment of fetal wellbeing.

Learning Objectives

To explore the structure of trauma services in the UK.

To understand the principles of trauma management and important considerations in the pregnant patient.

To appreciate the maternal and fetal outcomes associated with trauma.