Articles Posted in Pregnancy

It is rare for  pregnant women to experience vaginal cord prolapse.  Of  the 1 in 300 cases that this happens, most vaginal cord prolapses are for reasons unrelated to car accidents. Umbilical cord prolapse is typically related to fetal abnormalities, having a baby in breech position, having an unusually long umbilical cord or due to carrying multiple fetuses.  In a few rare cases, after a traumatic auto impact a woman can experience umbilical prolapse, especially if the impact sets of a premature labor. If a mother already had one of these abnormal circumstances, a severe impact while pregnant, may trigger a premature birth or ruptured membrane which then can lead to umbilical cord prolapse.

If an expectant mother’ amniotic sac breaks after a car accident and  the mother-to-be feels that the umbilical cord has slipped out into the vagina she will want to take pressure off the cord.  Stop standing. By getting onto your hands and knees, this will help remove some pressure. Additionally, this naturally pushes the uterus up and keeps the baby’s head from putting pressure on the cord.  If you can feel the cord has protruded, use a clean towel and support the cord until help arrives.  Providing support prevents gravity from allowing the cord to prolapse farther.

While in an ambulance being transported to the emergency room, the mother-to-be should expect that the EMT may take over holding the head of the baby and/or the cord while she remains on her knees.  Additionally, they may apply a moist dressing to use to hold the umbiblical cord to prevent it from drying out.

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In my practice, I have seen on more than one occasion, pregnant women diagnosed with low amniotic fluid after a car accident.  In some cases, it was not at all shocking to the expecting mother.  Especially is this so if she had experienced vaginal leakage post-collision.  Other times, the news is surprising when little to no leakage occurred after the collision. Sometimes, the mother became aware of the diagnosis after she saw her OBGYN for issues she may have thought were minor or perhaps she believed to be unrelated to her car accident.  These symptoms may have included  a persistent chill, a severe headache, facial swelling, failure to gain weight or blurriness.

Officially, low amniotic fluid will be diagnosed as oligohydramnios.

The amniotic fluid is important to the development of a healthy baby.  As expectant mothers already know, this fluid surround the baby and helps cushion him should the expectant mother take a fall or be involved in a car accident.  The amniotic fluid also keeps the umbilical cord from being compressed, regulates the little ones temperature, and allows the baby to move, stretch and ‘swim.’ These movements made by the baby while still in the womb helps the baby develop muscles.

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Without a doubt, most expectant mother’s will go to their OBGYN, an emergency room or an urgent care center after a car accident.  The overall health of both the mother and her child as well as the outcome of the pregnancy may depend on these actions. Early detection of abnormalities with a pro-active approach goes a long way to ensuring a normal pregnancy after an auto accident.

It should be also noted that many pregnant women are involved in car accidents and proceed to give birth to healthy children and continue to experience a ‘normal’ pregnancy post-collision.

However, from time to time, an impact may cause significant harm to the unborn child or the mother-to-be.

Unfortunately, pregnant women are not excluded from being involved in traffic accidents. In most cases, the pregnant woman is the driver of the vehicle, which puts her at greater risk of injury due to the airbag or to the steering wheel.

A recent study looked at the need for immediate triage, treatment and follow up of pregnant women after several different types of traffic accidents. The study looked at five years of traffic accidents involving pregnant women which involved 35 women who were involved in a traffic accident at between 22 to 39 weeks of gestation. Of the total, fifteen of the women were involved in front end impact collisions. All of these women had mild symptoms after the accident but all the infants survived and were delivered at the normal time.

Fifteen other women were broadsided as a part of their traffic accident. Two were riding a bicycle and got injured in a bicycle-automobile collision. Of the women involved in a broadside collision, most had clear objective findings and some needed tocolytics in order to stop contractions. Some of these women needed hospitalization for up to eight days. It appears that broadside impacts are much more severe to pregnant women than head on collisions. Even so, most did not have an adverse impact on the outcome of the pregnancy and these women had healthy babies as well.

Pelvic fractures are particularly dangerous in pregnancy, when it can disrupt blood flow to the uterus or cause direct trauma to the uterus. Pelvic fractures are fortunately rare in pregnancy, occurring mostly from automobile accidents or falls from great heights.

One study looked at the relationships between the type of pelvic fracture and maternal fractures leading to various outcomes stemming from the fractures. The study looked at the literature showing maternal pelvic fractures and acetabular fractures. A total of 101 cases were discovered in the literature and researchers looked at the factors that went into maternal or fetal morbidity and mortality.

They found that there was a high maternal and fetal mortality rate associated with pelvic fractures. A total of 9 percent of mothers died and a total of 35 percent of the fetuses died, mostly secondary to pelvic fractures sustained in automobile pedestrian accidents. Those involved in pedestrian accidents had the highest maternal and fetal mortality rate, especially when compared to falls. As it turned out, the classification of the fracture (complex versus simple), the fracture type (pelvic versus acetabular) and the trimester of pregnancy did not influence the rate of death from these accidents.

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