When trauma occurs during pregnancy, the first priority is the stabilization of the mother. The most common cause of fetal death is maternal death. Ultrasound of the maternal abdomen should be accomplished early after significant blunt trauma.1 The uterus is well protected within the pelvis during the first trimester of pregnancy; however, during the second and third trimesters, it is at much greater risk of injury due to its intraabdominal position. The sonographic appearance of intraperitoneal blood may be noted in the pelvis before it is detected in the Morison's pouch or elsewhere. Signs of fetal distress may be the first warning sign of occult maternal hemodynamic compromise. After maternal stabilization, the well-being of the fetus should be evaluated. Placental abruption and direct fetal injury must be suspected following significant maternal trauma in the second and third trimesters.
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