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The risks that maternal trauma pose to a fetus

Maternal trauma, or pregnancy-related injury, poses several risks to the fetus, especially if surgery is required. Expecting mothers in Arizona might not be surprised to find out that violence and traffic accidents are the most common causes of trauma in pregnant women, and this trauma is more likely to cause maternal death than other pregnancy-related medical complications.

Between 1987 and 1991, the New York City Medical Examiner recorded traumatic deaths among mothers aged 15 to 44. While 7 percent of these traumatic death cases involved drug overdoses, 12 percent were because of trauma from motor vehicle accidents, 13 percent were from suicide and 63 percent were homicides.

Pregnancy-related injuries are threatening to the health of the fetus, and medications and treatments that the mothers receive might be risky as well. One main risk to the fetus at the time of maternal trauma is surgery on the mother. The fetus could die if the mother's hematocrit drops more than 50 percent, blood pressure drops 20 percent or oxygen saturation falls below 90 percent, causing inadequate oxygen supply to the fetus.

However, the biggest surgical risk is the preterm delivery of the fetus. At fewer than 23 weeks, preterm delivery usually results in the newborn's death. While newborns have a greater chance of survival after the 25th to 28th week of pregnancy, they could still suffer major long-term defects. At 25 weeks, there is a 50 percent chance of a newborn suffering a major long-term defect after preterm delivery. This risk drops to 20 percent at 28 weeks.

Although violence and motor vehicle accidents are the most common causes of pregnancy-related injuries, physician mistakes could also be a cause of maternal trauma. A mother who believes that her medical team or facility is responsible for an infection or injury that causes defects to or the death of her baby might have a case for medical malpractice. The mother could engage a lawyer to help her build a case and seek fair compensation.

Source: Medscape , "Overview", Steven D Schwaitzberg, MD , November 17, 2014

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