Obstetric trauma — DipIMC MCQ

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HardPaediatric and Obstetric EmergenciesObstetric traumaDipIMC

A 28-week pregnant passenger is involved in a high-speed collision. She has abdominal pain, seatbelt bruising and feels faint when supine. What is the most appropriate management?

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Correct answer: E — Assess and resuscitate as a trauma patient with left uterine displacement

Assess and resuscitate as a trauma patient with left uterine displacement is the best answer because maternal resuscitation is fetal resuscitation and aortocaval compression should be relieved. Give unrestricted crystalloid to normalise blood pressure is less appropriate because over-resuscitation can worsen bleeding when haemorrhage is uncontrolled; Provide reassurance and reassess after transport is less appropriate because reassurance is inadequate for an evolving major trauma problem. Immobilise every joint and delay departure for a detailed examination and Use oral analgesia as the main treatment are also suboptimal because they move attention away from the key pre-hospital priority.. The key DipIMC principle is to treat immediate reversible threats, communicate clearly and move the patient toward the right definitive care.

Reference: JRCALC Guidelines; Resuscitation Council UK Guidelines; NICE Major Trauma NG39