Abstract
Trauma during pregnancy is the leading non-obstetric cause of morbidity and mortality,
and accounts for five per 1000 fetal deaths. Direct fetal injury due to trauma during
pregnancy is rare, and limited information is available about how to optimize fetal
outcomes after injury. Early recognition and appropriate management of direct fetal
trauma may improve outcomes for the fetus. There are currently no available guidelines
to direct management of the injured fetus. We provide a detailed literature review
of the management and outcomes of direct fetal injury following blunt and penetrating
injury during pregnancy, and describe a suggested initial approach to the injured
pregnant patient with a focus on evaluation for fetal injury. We identified 45 reported
cases of blunt trauma resulting in direct fetal injury, with 21 surviving past the
neonatal period, and 33 of penetrating trauma resulting in direct fetal injury, with
24 surviving past the neonatal period. Prenatal imaging identified fetal injury in
19 cases of blunt trauma and was used to identify bullet location relative to the
fetus in 6 cases. These reports were used to develop management algorithms for the
injured fetus.
Keywords
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Article info
Publication history
Published online: February 05, 2022
Accepted:
January 22,
2022
Identification
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