POST-TRAUMATIC HEMORRHAGE IN A PREGNANT WOMAN IN THE PRACTICE OF PRIMARY EMERGENCY MEDICAL TEAMS

Abstract

Pregnancy is a unique period in a woman's life. It involves physiological changes, as well as mental and emotional ones for the mother-to-be. Pregnant women are at a higher risk of death from trauma compared to the rest of the female population. Medical activities aimed at treating pregnant trauma patients are issues that pose serious challenges for members of emergency medical teams. They require interdisciplinary medical knowledge, that of anatomy, physiology, trauma, but also obstetric and possibly neonatal care. In the pre-hospital setting, diagnosis and assistance is severely limited, so it is crucial that the pregnant woman be brought as quickly as possible to a hospital with appropriate diagnostic and specialty facilities. The aim of this study was to discuss the problem of uncontrolled internal hemorrhage in a pregnant woman, its consequences and the pre-hospital management of primary emergency medical teams. The research method was a review of the literature and recommendations of specialists of international organizations established to develop guidelines for emergency medicine. Based on the analysis, the following conclusions were drawn: 1. A traumatized pregnant woman should be given priority and special treatment in prehospital care due to measures that affect at least two lives - that of the mother and that of the child/children. 2. Due to the changes taking place in the body of the mother-to-be, injuries in pregnant women occur more frequently than in women who are not pregnant. 3. In pregnant women, the forces acting during the trauma, lead to different injuries than in non-pregnant women. 4. The effects of injuries sustained during pregnancy depend on the mechanism of injury, the severity of the injury and the stage of pregnancy. 5. Hypovolemia associated with decompensation of traumatic shock in a pregnant woman indicates an inauspicious prognosis for the health and life of the mother and baby. 6. Medical emergency procedures in pregnant trauma patients are similar to those used for other patients, but require some modifications related to the anatomical and physiological changes that occur during pregnancy. 7. Examining a pregnant patient may be difficult due to the anatomical and physiological changes occurring during this period. Increased heart rate and decreased blood pressure should not be considered a consequence of pregnancy if other causes are not ruled out. 8. It seems reasonable to introduce TXA acid into the regimens of basic emergency teams for victims with symptoms of hemorrhagic shock.