Pregnancy and you blog

Don't ignore abdominal trauma while pregnant

By Mary M. Murry, R.N., C.N.M. April 21, 2009

Suppose you're about 30 weeks pregnant and your toddler, in all innocence, jumps on you and lands on your abdomen? Should you worry? What if you're nine weeks pregnant and are in an automobile accident, wearing your seat belt of course. Is your baby in danger?

I would like to reassure you and caution you also. Abdominal trauma in pregnancy isn't something to be ignored. It's a major contributor to maternal mortality and is the leading cause of pregnancy-associated maternal deaths in the United States, or deaths that may be causally related to pregnancy.

Motor vehicle accidents are responsible for about two-thirds of maternal trauma cases in developed countries, according to an article in the American Journal of Obstetrics and Gynecology in 2007. Domestic violence, assaults, falls and burns account for the majority of the remaining trauma. As strange as it seems, pregnancy appears to be a risk factor for being assaulted in the United States.

When you consider trauma to the abdomen in pregnancy, you have to remember there are two who possibly suffer from the trauma. Pregnant women are more likely than non-pregnant women to sustain abdominal trauma. Our abdomens stick out farther and our internal anatomy is altered.

As to my first question, if your toddler has accidentally landed on your abdomen, you should call your OB provider right away. More than one-half of losses are related to minor trauma. You may be asked to go into the hospital for monitoring, possible blood work and/or ultrasound.

How long you'd be monitored depends on several factors; contractions, vaginal bleeding and abdominal pain.

If you're in your first trimester and experience abdominal trauma, you're very unlikely to experience a loss of your pregnancy. The uterus and baby are protected by your pelvis. If you've any concerns after abdominal trauma, don't hesitate to ask an OB provider if you need to be concerned.

There are things you can do to help prevent trauma. Always wear your seat belt correctly. In pregnancy, the lap belt should be placed under the uterus and the shoulder belt should be positioned between the breasts, to the side of the uterus and over the middle portion of your collar bone.

Domestic violence often begins in pregnancy. If it's occurred before pregnancy, it's likely to increase. If you're a victim of domestic violence, don't hesitate to protect your baby and yourself by seeking help including a women's shelter.

April 21, 2009