Special considerations for major trauma in pregnancy and childhood

Abstract

Managing trauma in pregnant women and children is challenging due to their unique anatomical and physiological features. This paper aims to explore the special considerations needed for trauma management in these vulnerable populations, emphasizing the need for patient-centred approaches. Trauma in pregnancy involves a balance between maternal and fetal well-being, requiring adjustment to resuscitation protocols, to tailor for the maternal physiological changes during pregnancy, and continuous fetal monitoring with the collaborative help of neonatologists and obstetricians. The challenges in paediatric trauma are focused on avoiding long-term developmental defects, especially after growth plate injuries that may lead to limb discrepancies, or complete growth arrests. This requires age-specific interventions and a robust rehabilitation strategy to minimize long-term complications following trauma. This paper also highlights the importance of simulation-based learning and medico-legal understanding for orthopaedic trainees. Future studies should focus on optimizing maternal and fetal health following trauma, with a focus on delivery methods, and creating innovative strategies to minimize long-term outcomes in paediatric patients. Understanding the unique nature of these vulnerable populations allows the clinician to respond effectively, optimizing the outcomes and trauma care.