Trauma in Pregnancy
Modified ATLS for pregnant trauma patients.
Updated: 05/03/2025
PregnancyATLSPerimortem C-sectionOBRhoGamOn this page2 sectionsHide sections
⚠️ Early OB consult required.
⚠️ 4-minute rule for perimortem C-section (attending required).
🚨Key ATLS Modifications
▼- Airway: early intubation if GCS <8. Difficult airway (edema). Most experienced provider.
- Breathing: chest tubes 1–2 spaces above inframammary fold (elevated diaphragm)
- Circulation: left lateral uterine displacement ≥20wk. Volume > pressors. Norepinephrine if refractory.
- MTP same as adults EXCEPT: fibrinogen target >200
- If O- RhD negative not available → RhD+ acceptable; give RhoGam after
⏱️
4-minute rule: CPR >4 min with gravid uterus ≥20wk → perimortem C-section. Fetal femur ≥4cm = ≥20wk on US.
🔬Labs & RhoGam
▼- Kleihauer-Betke (>20wk)
- Rh typing for ALL pregnant trauma patients
- Rh-negative + abdominal trauma/vaginal bleeding → RhoGam within 72h (OB-guided)
- Coags: INR, PTT, fibrinogen, FSP — abnormalities may indicate abruption
- Status
- AHS Official Protocol
- Source
- Trauma-Pregnant-Patient-2025.docx
- Last reviewed / updated
- 05/03/2025