Abdominal Trauma in Pregnancy - Essay Example

Abdominal Trauma in Pregnancy Introduction Trauma in pregnancies continues to pose threat to lives of different pregnant women in the world today. As it stands, it is one of the main causes of maternal and the fetal deaths in the US (Petrone et.al, 2010). Hector et.al (2013), estimates the abdominal trauma cases to be in one pregnant woman in every sample of twelve. Cases of trauma in pregnancies continue to be amongst the most challenging tasks for most doctors in the world since it means that two lives are at stake; the life of the mother and that of the fetus. They both stand a risk of death and hence they require proper evaluation and management at all times. Treatment of expectant mothers is a bit complicated following the changes they undergo in their bodies as a result of the pregnancy; psychological changes and anatomical developments (Wall et.al, 2014). Therefore, abdominal trauma results in loss of life of both the mother and the unborn or just the unborn since predictions on outcomes of the fetus after a trauma are not an easy task for most doctors (Shah et.al, 1998). Instead of the mothers losing their life, they at times opt for a spontaneous abortion. The estimated fetal deaths related to abdominal traumas in pregnancy cases have been estimated to be around three percent in every a hundred thousand normal births (Hector, et.al, 2013). So as to adequately cater for the adequate number of abdominal trauma cases, most of the countries of the world especially the developed nations have established special facilities with special obstetricians and gynecologists to attend to such fatal cases. Different researches by different scholars of the world have also helped in identify the most vulnerable women amongst the women populations of the world such that adequate preventative strategies are implemented to curb trauma cases. In the early stages of a pregnancy, the uterus of the mother bulges and becomes vulnerable to damages that can be inflicted on the body of an expectant mother of both blunt and penetrating nature (Rudra et.al, 2007). Following the early stages of the gestation period the uterus develops accordingly to become an umbilicus but eventually reaches a maximum extent. During the pregnancy, the fetus in the womb is normally protected well by the amniotic fluid but in occurrences of trauma the amniotic fluid may cause embolism resulting in harm of the fetus (Rudra et.al, 2007). During the pregnancy, the heart beat is likely to increase with about fifteen or more heart beats per minute. This depicts the fact that the blood pressure gradually increases since the heart output is eventually increased. This also means that some women are likely to suffer from hypertension problems in late stages of their pregnancies. However the placenta which is an elastic tissues membrane reaches its maximum length of expansion just like the uterus. Trauma during a pregnancy that is direct to the placenta or the uterus causes the body release agents which are both advantageous and disadvantageous to the pregnant mother (Rudra et.al, 2007). Pregnant mothers therefore experience a number of changes in their bodies which in turn make them vulnerable to different causes of trauma. These changes include: general gain of weight as a result of increased uterus and enhanced breasts, increased respiratory functions in the body that result into increased levels of oxygen consumption as well as decreased residual functions. In cases of interruption of oxygen supply to the bodies of the pregnant mothers, the life of the fetus is at risk since the fetus has to be always supplied with the oxygenated blood (Rudra et.al, 2007). Types of abdominal trauma Basically, abdominal trauma in pregnancies can be classified into three; minor, blunt and penetrating trauma. Minor trauma These are traumas arising from minor incidents such a baby and in this case a toddler unintentionally jumping on the belly of an expectant mother. They are very common in life of different mothers. Blunt Trauma These are the traumas in pregnancies that normally arise from major incidents such as accidents or fatal car crash that adequately inflict damage to the body of an expectant mother. The work of the amniotic fluid is necessarily to protect the fetus from shocks instilled by the blunt trauma (Rudra et.al, 2007). It does so by adequately dispersing the force in all directions. However, the amniotic fluid may not necessarily shield the fetus from harm of the injuries arising from severity of the blunt trauma. Such injuries may lead abruption of the placenta resulting to death of the mother and fetus and maternal shocks that may also result in death of the fetus but the mother may survive. Penetrating trauma These normally arise from incidences of gunshots or stabbing. However, the maternal mortality rates associated with the penetrating traumas are a bit lower when compared to blunt trauma. Following the expansion of the uterus during the pregnancy, some organs of the body get misplaced. They are either pushed up or down. An example is the bowel that is pushed upwards. Therefore, in cases of stab injuries in the upper abdomen, is likely to damage the intestines and other body organs which are quite dangerous for the expectant mother. On the other hand, in later stages of the pregnancy, a stab on the lower abdomen is advantageous to the pregnant mothers for the amniotic fluid and the placenta adequately absorbs the shocks of the piercing object ensuring that is causes minimal damages (Rudra et.al, 2007). Major causes of abdominal trauma in a pregnancy Vehicle accidents and clash Vehicle accidents are likely to result into major body injuries such as head or even neck injuries. Such injuries are likely to result into failure of breathing as a result of damaged body organs and also major internal injuries to the bodies of the expectant mothers hence resulting into a number of maternal deaths (Rudra et.al, 2007). The degree of severity of such injuries determines not only the life of the mother but also the life of the fetus. According to Hector et.al (2013) in every a hundred thousand pregnancies there are approximately two hundred and seven cases are related to car accidents and clashes. This highly contributes to the number of deaths related to pregnant mothers as well as fetal deaths. In fact it is the leading cause of maternal related deaths (Brown, 2009).The risky factors attributed to this cause of abdominal trauma during the pregnancy include inappropriate use of the safety belts in both cases of an expectant mother driving or being driven. Also, use of intoxicants has as well been tested as a risky factor in vehicle accidents and clashes since several studies have revealed its contributions to some cases of motor vehicle accidents which have involved pregnant mothers. Domestic violence incidences This is one of the most common causes of intentional trauma during pregnancy. According to Hector et.al (2013), in more than sixty studies that have been conducted in more than twenty nations of the world, there is a frequency of a domestic violence during pregnancy that range from approximately one to sixty percent. Domestic violence may be verbal, emotional or even physical and their outcomes are similar. The risky factors in this case being unintended pregnancies, partner abuse, low education levels regarding how to handle pregnant mothers, socioeconomic statuses and in this case in lower ones, violent partners prior the pregnancies as well as the unmarried statuses. Falls and slips As the fetus grows inside the womb of a pregnant mother, the mother gain weight and the joints become a little weaker to withstand the increase in weight. This adequately make pregnant women fall since the stability is deemed to reduce with the pregnancy moving from one stage to another. According to Hector et.al (2013), in a sample of four pregnant women one falls at least once during the stages of the pregnancy with most of these falls occurring indoors and some other falls attributable to stair falls. Different researches by several scholars have revealed risky factors in this case to include the slippery floors, walking in hurry or even the expectant mothers carrying along heavy objects. Poisoning In both the intentional poisoning and attempts to commit suicide by the expectant mothers, different researches have revealed possible loss of life to both the mother and the fetus. Intentional poisoning cases eventually arise from possible occurrences such as overdoses. However, the poisoning can also be accidental in situations such as dental poisoning (Hector et.al, 2013). Poisoning can therefore be attributed to both internal and unintentional trauma during pregnancies. Burns and electric shocks Burns in pregnant mothers can result from heat produced by burning objects for example in a fire or heat arising from current and in this case electric heat or electric shocks. Hector et.al (2013) suggests that the survival of the mother and the fetus in this case depends on depth of the burn or even the surface area of the body affected by the burn. If the burn exceeds forty percent of the body surface there is likelihood that both the mother and the fetus would not escape the tragedy. The major burns are likely to alter the pulmonary functioning of the body. The most risky factor in such cases of burn inflicted trauma includes smoke inhalations or inhalation of other burning toxic products. However, burns that may occur in early stages of the pregnancies are more attributable to spontaneous abortions (Hector et.al, 2013). High voltage currents are likely to cause violent contraction of body muscles, fractures arising from falls as well as brain damages and with the fetus surrounded by the amniotic fluid, it stands a greater risk of dangers of electric shocks than even the mother (Rudra et.al, 2007). Gun shots and stabbing These are the major causes of the penetrating trauma where piercing objects damages vital body organs of the expectant mother. Gunshot wounds and knife-stabbing wounds have in the past years accounted for a significant proportion of the reported trauma cases in major hospitals. According to Hector et.al (2013), penetrating trauma in expectant mothers is highly attributable to increase in deaths of the fetus, increased stay of the mothers in hospitals for more care and increased complications than the other forms of traumas and hence certain causes of maternal deaths. Conclusion Abdominal traumas continue to be a big challenge to the health and safety of different expectant mothers of the world. It is therefore important for all the doctors of the world to adequately undertake pregnancy tests on women bearing an age of pregnancy who have been involved in trauma incidences so as to adequately find ways of taking care of the mother and the baby as early as possible. There is also need of managing the pregnant women and educating them on the necessary preventive measures of avoiding trauma such as adequate use of the safety belt and avoiding carrying heavy objects. References Brown, H. (2009). Trauma in pregnancy. Obstet Gynecol. 114(1), 147-60. doi: 10.1097/AOG.0b013e3181ab6014. Hector, M et al. (2013). Trauma in pregnancy: an updated systematic review. American Journal of Obstetrics & Gynecology. Retrieved from http://www.salamandra.edu.co/archivos/articulos/12.TRAUMA%20EN%20EL%20EMBARAZO.pdf Petrone, Patrizio , Talving, Peep , Browder, Timothy, Teixeira, Pedro, G., Fisher, Orna, Lozornio, Alfredo, Chan, Linda S. (2010). Abdominal injuries in pregnancy: a 155-month study at two level 1 trauma centers. International Journal of Care of the Injured, 42(1), 47–49. Rudra, A., Ray, A, Chatterjee, S., Bhattacharya, C., Kirtania, J., Kumar, P., Das, T. & Ray, V. (2007). Trauma in Pregnancy. Indian J. Anaesth., 51(2), 100 – 105. Shah, K et al. (1998). Trauma in Pregnancy: Maternal and Fetal Outcomes. Journal of Trauma Injury Infection &Critica Care, 45(1), 83-86. Wall, S., L., Figueriredo, F., Laing, G., L., Clarke, D., L. (2014). The spectrum and outcome of pregnant trauma patients in a metropolitan trauma service in South Africa. International Journal of Care of the Injured, 45(8), 1220–1223. Read More