ABDOMINAL TRAUMA IN PREGNANCY
Need to be examined for uterine tenderness, ctx, FHT, vag
exam for ROM, bleeding, cervical dilatation;
Kleihauer-Bethke; NST if far enough along
Major risk is abruption
If pt complains of or is found to be contracting, need to
try to r/o abruption: In addition to above, do u/s, CBC,
fibrinogen, 24h fetal monitoring. n.b. nl fibrinogen
>400; <300 is cause for concern. Tocolyze if
contracting; use Mg; avoid terbutaline b/c makes it
impossible to monitor HR as a sign of blood loss
Have pt watch for contractions, bleeding, or change in
pain
If at > 20wks:
- If < 3/h ctx then monitor x 4h then d/c
- If 3 or more ctx/h then monitor x 24h then d/c