Anesthetic Considerations of Polytrauma in Pregnant Females

Abstract

Trauma is a significant cause of morbidity and mortality in women of childbearing age. Injury during pregnancy occurs in up to 8% of pregnant women and is the most frequent cause of non-obstetric maternal and fetal mortality. Anatomical and physiological changes during pregnancy influence patterns of injury and the patho- physiological responses of the patient to the injury. Trauma from road traffic, falls and domestic violence are the most common causes of blunt trauma. Other modes of trauma includes penetrating trauma, head injuries, thoracic trauma and burns. Optimal management of the pregnant trauma patient requires a multidisciplinary approach. The anesthetist and critical care physician play an important role in the fetomaternal care, from initial assessment, resuscitation and intraoperative management. Primary goals are resuscitation of the mother and maintenance of uteroplacental perfusion and fetal oxygenation by the avoidance of hypoxia, hypotension, hypocapnia, acidosis and hypothermia. Recognizing and understanding the mechanism of injury, the factors that may predict fetal outcome, and the pathophysiological changes that can result from trauma, will allow early identification and