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Midwifery triage and management of trauma and second/third trimester bleeding

✍ Scribed by Jackie Tillett; Lisa Hanson

Publisher: Elsevier Science
Year: 1999
Weight: 157 KB
Volume: 44
Category: Article
ISSN: 0091-2182
DOI: 10.1016/s0091-2182(99)00084-1

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✦ Synopsis

Trauma affects approximately 8% of all pregnancies, and bleeding affects nearly 5% of gestations. These two conditions are potentially life-threatening and require immediate management by the midwife.

Trauma in pregnancy is commonly caused by motor vehicle accidents, falls, and assault. Although abruption resulting from trauma is a rare occurrence, injury caused by domestic violence, is associated with the greatest risk of obstetric complications.

Bleeding in pregnancy has a number of etiologies. Midwives are well-prepared to safely and competently make a differential diagnosis of bleeding in the second and third trimesters.

A sequence for midwifery triage of clients who present to the emergency room/triage area for trauma and bleeding is presented. Considerations for stabilization, history, physical examinations, diagnostic testing, initial management, and follow-up are described. Practical considerations for midwifery services incorporating provisions for triage into their caseloads are also provided. J Nurse Midwifery 1999;44:439 -48 ᭧ 1999 by the American College of Nurse-Midwives.

* CNMs/CMs and midwives as used here in reference to those midwifery practitioners who are certified by the American College of Nurse-Midwives (ACNM) or the ACNM Certification Council, Inc. Midwifery refers to the profession as practiced in accordance with the standards promulgated by the ACNM.

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