Blunt abdominal trauma

1. Blunt abdominal trauma secondary to motor vehicle accidents is the leading cause of nonobstetric-related fetal death during pregnancy, followed by falls and assaults. Uterine rupture or laceration, retroperitoneal hemorrhage, renal injury and upper abdominal injuries may also occur after blunt trauma.

2. Abruptio placentae occurs in 40-50% of patients with major traumatic injuries and in up to 5% of patients with minor injuries.

3. Clinical findings in blunt abdominal trauma. Vaginal bleeding, uterine tenderness, uterine contractions, fetal tachycardia, late decelerations, fetal acidosis, and fetal death.

4. Detection of abruptio placentae. Beyond 20 weeks of gestation, external electronic monitoring can detect uterine contractile activity. The presence of vaginal bleeding and tetanic or hypertonic contractions is presumptive evidence of abruptio placentae.

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