Carry or memorize an obstetric quick-reference card (“patient-contact finder”) for every call that might involve pregnancy (trauma OR medical).
Core questions to ask EVERY pregnant patient:
• Gestational age – “How far along are you?”
• Last menstrual period (LMP) – establishes possible due date.
• Gravida / Para – total pregnancies vs. live births; higher para generally = faster deliveries, different pain expectations, possible uterine tone issues.
• Known complications – gestational diabetes, hypertension, placenta previa, multiples, breech, etc.
• Prenatal care & treating OB / delivery hospital – try to honor patient preference when not emergent.
• Vaginal bleeding or fluid loss – quantity, color, clots.
• Pain / contractions – onset, frequency, intensity.
• Rupture of membranes (“water broke”) – time, color (clear vs. meconium), odor.
• Fetal movement (“kick counts”) – decreased or absent movement since the event is ominous.
• Seat-belt position at impact – lap belt should be under the belly across iliac crests.
• Mechanism details – speed, direction, restraint type, air-bag deployment, interior intrusion.
Parity, Gravida, and Labor Considerations
Gravida = total number of pregnancies.
Para = number of deliveries ≥20 wks (live or stillborn).
Higher para often → faster cervical dilation and easier expulsive stage (“It’s easier after the first one”).
Myth chatter: full moons and labor onset – unproven but widely believed; cited as effect of lunar gravity.
Field Management of Pregnant Trauma Patients
Seat Belt & MVC Assessment
- Correct placement: lap belt below uterus, shoulder belt between breasts.