Dawaa Reference

chronic

Trauma in pregnancy

Treatment options, dosing, cautions and Egyptian brands from the shipped Dawaa Reference card.

Evidence status

Checked against the sources named below

Sources3 sources

ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class WD35 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care · Pregnancy Trauma - StatPearls - NCBI Bookshelf - https://www.ncbi.nlm.nih.gov/books/NBK430926/

Verified against1 document
  • No dose - referral pathway, no medicine given in primary care

Verified date2026-08

Presentation reference

Is it this?

Reference only, to read alongside your own examination.

Symptoms — what the patient reports (9)

  • Run the standard trauma algorithm: primary, secondary and tertiary survey
  • Vital signs shift through normal pregnancy, so read them against pregnancy values
  • Ask every woman of childbearing age whether pregnancy is possible and send a beta-hCG
  • Ask about previous preterm labour, placental abruption and placenta praevia
  • Get obstetric help urgently, above all in the second or third trimester
  • Bleeding from the vagina before labour is always abnormal [vaginal bleeding]
  • It may mean abruption, early labour, the cervix opening early, or placenta praevia
  • Cloudy, white or green discharge suggests the membranes have gone, raising infection risk
  • Contractions after an injury are a concerning finding [uterine contractions]

Signs — what you find (10)

  • Concerning findings: penetrating abdominal injury, vaginal bleeding, ruptured membranes, a bulging perineum, contractions or an abnormal fetal heart rate [uterine contractions · vaginal bleeding]
  • Ruptured membranes risk cord prolapse, an obstetric emergency needing immediate caesarean
  • If the circulation allows, include a speculum examination
  • Palpate for fundal height, which estimates gestation and may be the only clue in an unresponsive patient [loss of consciousness]
  • The uterus rises above the pubic bone between 8 and 12 weeks
  • From 20 weeks it climbs about a finger’s breadth at a time until 40 weeks
  • It reaches the sternum at 36 weeks, then drops as the head engages
  • A fundal height that does not match known dates suggests uterine injury, twins or growth restriction
  • Avoid low blood pressure and give oxygen, because the fetus tolerates hypoxia badly [hypotension · hypoxia]
  • If rapid sequence intubation is needed, pregnancy calls for lower doses of suxamethonium

Tests (12)

  • Fetal heart sounds can be heard with a stethoscope from 20 weeks; before that use a Doppler
  • They are detectable from as early as 12 weeks, usually between 110 and 160 bpm
  • Fetal hypoxia first shows as a fast heart, then slows as oxygen falls further
  • Any sustained rate below 120 bpm means fetal distress, and points to maternal blood loss
  • Past 24 weeks, monitor the fetal heart for 4 to 6 hours after arrival
  • Fear of radiation must not delay the right diagnosis; the mother comes first, not the fetus
  • An abdominal x-ray gives the fetus 0.1 to 0.3 rads; abdominal and pelvic CT gives 3 to 4 rads
  • A pregnancy should accumulate under 10 rads in total, and no one study should pass 5 rads
  • Between 8 and 15 weeks a high dose (>10 rads) may cause growth restriction and brain defects; past 15 weeks no dose-dependent effect appears
  • Ultrasound and MRI have no known harmful effect on the fetus
  • Keep eFAST in the secondary survey; it finds blood or air in the chest, round the heart, or in the abdomen
  • Radioactive iodine must not be given therapeutically in pregnancy

If not this — what else fits (5)

  • Blunt abdominal trauma heads the listed differential
  • Placental abruption needing emergency management
  • Penetrating abdominal trauma completes the three
  • Free fluid confined to the pelvis on ultrasound is of unclear meaning in pregnancy
  • MRI is safe in pregnancy but often impractical in an emergency, on availability and time

SourceStatPearls "Pregnancy Trauma" - disease-level clinical article

Presentation findings are traced to the source above.

1

NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)

1st line
Adult dose and duration

Trauma during pregnancy (falls, road traffic accidents, domestic violence) requires urgent assessment of both mother and fetus; the GP recognises and refers to obstetric emergency care. - Refer, with advice

Paediatric dose

Adult-only condition - paediatric section not applicable

Dose source

No dose - referral pathway, no medicine given in primary care

Why

Trauma during pregnancy (falls, road traffic accidents, domestic violence) requires urgent assessment of both mother and fetus; the GP recognises and refers to obstetric emergency care.

Cautions
  • Abdominal trauma in pregnancy with bleeding, contractions, or reduced fetal movement needs immediate obstetric referral for possible placental abruption.
  • No medicine is prescribed for this in primary care - this entry is for recognition and referral. Anything given is decided by the service it is referred to.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.