‘Can a bump kill my baby?’

Many moms-to-be take extra care to avoid any kind of trauma to their own bodies in order to protect the developing foetus. The families, friends and colleagues of a pregnant woman may also feel that she should exercise caution so as to avoid miscarrying her baby. Here are some facts about miscarriage as a result of physical trauma, and whether or not you’re at risk*:

First trimester miscarriage

Miscarriage is common- occuring in around 1 out of 5 pregnancies- but rare during the first trimester as a result of physical trauma, as the foetus is protected by the pelvic bones. What could cause miscarriage would have to be what is known as “catastrophic trauma”, which includes compound fractures of the extremities, haemorrhagic shock, damage to the liver or spleen or, obviously, maternal death.
Smaller, “non-catastrophic” trauma, such as light knocks, bruises or minor fractures to toes and fingers for example are not linked to miscarriages.

Second and third trimester miscarriage as a result of maternal trauma

While minor trauma is not associated with miscarriage in the first trimester, even relatively minor trauma may have adverse effects on both mother and baby during the second and third trimester. Minor and major trauma (a big fall or a car accident, for example) may cause placental abruption, pre-term labour, premature rupture of the membranes, uterine rupture or injury directly to the foetus.

Here are some of the major causes of such injuries:

• Rapid acceleration or deceleration or a direct blow to the abdomen could cause placental abruption- the shearing away of the placenta from the foetus, depriving the foetus of oxygen supplied via the placenta. Placental abruption consequences vary- a very slight placental abruption may have no ill effects on the baby or mother, while a complete detachment has very serious, possibly fatal, consequences to mother and baby.
• Premature labour may begin; usually regular contractions start within four hours of the traumatic event, progressing to the point of delivery. Premature rupturing of the foetal membranes may also result in premature delivery.
• Injury directly to the foetus may result in bruising, fractures or foetal death.
• Uterine rupture usually results in the loss of the foetus.
• The severity of the injury to the pregnant  woman does not necessarily mean that the baby experiences the same levels of trauma- even a minor trauma to the mom could have extremely traumatic consequences for the foetus.
• Miscarriage or other adverse effects as a result of trauma are most likely to occur within a few hours of the traumatic event, including placental abruption within 72 hours, rupture of membranes within four hours, onset of early labour within four hours resulting in delivery, or foetal death within seven days of the traumatic event.
• Should none of those things occur directly following the traumatic event, it is unlikely that the trauma will introduce increased risks of pre-term deliveries, lower Apgar scores, Caesarean deliveries or extended neonatal stays in hospital.
  

Although contractions following trauma are common, pre-term labour and delivery are not, and pre-term delivery as a result of trauma (with the exception of pre-term delivery as a result of placental abruption) is no more frequent in traumatised women than it is in non-traumatised women.

When to call for help

If you've been through physical trauma, and you are experiencing any of the following symptoms, call your doctor for advice, even if they may or may not be related to the trauma:

• Vaginal bleeding or spotting.
• Swelling in your face or fingers.
• Leakage of fluid or increased vaginal discharge.
• Severe or unrelenting and constant headaches.
• Pain in your abdomen.
• Persistent vomiting that is not connected to morning sickness.
• Chills or a fever.
• Noticeable change in the frequency or strength of your baby's movements.
• Painful or urgent urination.
• Faintness or dizziness.
  

Don't forget that trauma may produce Post Traumatic Stress Disorder and depression which may also require counselling and possible treatment, even if the pregnancy is not compromised.

*Should you experience physical trauma during pregnancy it is wise to consult with your local clinic, gynaecologist or obstetrician for advice.

Information from: Military Obstetrics and Gynaecology Textbook.

Disclaimer: The views of columnists published on Parent24 are their own and therefore do not necessarily represent the views of Parent24.

Are you more aware of possible dangers to your body now that you’re pregnant?