The Pregnant Patient

Modifications of assessment of trauma patients in presence (or suspect) of pregnancy

1. When indicated a thoracostomy tube should be inserted 1 or 2 intercostal spaces upper than usual.
2. Vasopressors has to be avoided in pregnancy.
3. Perform L.U.D (Lateral Uterus Displacement) to relieve Inferior Vena Cava compression.
4. Transport the severely injuried pregnant patient to an hospital with maternal facility if fetus is viable (≥ 23 weeks).

Resuscitation of the pregnant trauma patient

1. The utilization of mechanical chest compressors is not recommended.
2. Continuous LUD should be performed during resuscitation.
3. No modification in energy level when electrical therapy is needed.
4. No modification in timing and doses of ACLS drugs.
5. Fetal assessment is not indicated during resuscitation.
6. Peri Mortem Cesarean Delivery (PMCD) has to be performed without delay and at the site of cardiac arrest (no transport is indicated), after 4 minutes of ineffective resuscitation attempts.