Dear Readers:

T.P. is a 24-year-old lady who is pregnant for the first time and is now about six months in gestation. She had a bad scare recently when she was involved in a motor-vehicle accident several weeks ago. She was not badly hurt herself but experienced neck, back and low abdominal pain for several days to weeks after the accident.

T.P. was seen by her family doctor after the accident when she experienced minor vaginal spotting. Her examination and ultra sound tests were normal and she rested for a few days. The slight vaginal bleeding cleared up. T.P., however, worries that the baby could have been hurt by the accident and that was why she experienced mild vaginal bleeding. She is also worried about having sexual relations with her partner. T.P. asks Lifeline if the baby could still be injured.

As it is now several weeks after the motor-vehicle accident and both mother and baby are stable and healthy, T.P. should now stop worrying. Her pains have settled, the minor vaginal bleeding lasted only two days and subsequent antenatal ultrasound examinations and physical examinations by her physical all remain normal.

A motor-vehicle accident does have the potential for a much worse outcome and T.P. is fortunate that she was only slightly injured. Motor-vehicle accidents, falls and direct assault, especially assault due to domestic violence, account for most cases of trauma during pregnancy. Recent figures show that as much as 20.6 per cent of pregnant teenagers and 14.2 per cent of pregnant adult women are physically abused during pregnancy.

Trauma during pregnancy is associated with increased risks of:

Spontaneous abortion

Early labour

Placental abruption

Foetal and maternal haemorrhage

Still birth

However, adverse pregnancy outcomes after minor trauma are rare. More than 90 per cent of all injuries to pregnant women are due to minor trauma. However, even after minor trauma, biochemical changes can occur in the mother which can cause the placenta to separate from the uterine wall and bleeding to occur. Because of this, every pregnant woman who experiences trauma should be fully examined and assessed by a medical doctor. A thorough physical examination by the doctor would include assessment of the health of the featus.

UltraSound examination would help confirm foetal-heart activity, foetal size and age and placental health (although ultrasound results are not conclusive for placental attachment and function). When abdominal pain and significant vaginal bleeding occur, the pregnant woman should be observed in hospital until symptoms resolve. After trauma, the woman should rest.

Certainly, after all these weeks, T.P. seems certainly well enough to resume sexual intercourse.

Write to:

Lifeline

PO Box 1731

Kgn 8