During pregnancy, many women are haunted by the fear of falling. And it has good reasons. Clumsiness of gait associated with a shift in the center of gravity, difficulty viewing due to a large belly can easily lead to a fall. This is especially likely on later pregnancy. However, nature took care to protect the baby as much as possible.

Child protection

The child is most protected early stages pregnancy. During this period, the uterus and embryo are hidden in the pelvic cavity and are securely hidden behind its bones.

As the period increases, the uterus begins to protrude beyond the pelvic ring and becomes more vulnerable. But at the same time the volume also increases amniotic fluid surrounding the embryo. They play the role of a shock absorber, a softening pillow. It is the waters that take the main blow and dampen its force due to vibrations.

But it would be wrong to say that a fall during pregnancy is absolutely harmless to the child or the expectant mother. On the contrary, it can lead to very serious consequences.

The outcome of the injury depends on which area the woman fell on - the stomach, back or side.

Falling on your stomach

When you fall on your stomach, the entire force of the impact is directed specifically at the uterus, especially after 12–16 weeks of pregnancy. For the most part it is extinguished by amniotic fluid. But the vibrations that arise in this case can themselves harm the baby. The principle of their action is similar to the blows of waves in a raging sea.

If the fall during pregnancy was serious and the injury was severe enough, it can lead to the following consequences:

• Miscarriage or premature birth.
• Premature abruption of a normally located placenta.
• Bleeding.
• In the later stages, there may be direct damage to the child - bruises and even fractures.

With such a fall, the expectant mother not only experiences severe stress. By instinctively stretching her arms forward, she has every chance of getting fractures in the bones of the forearm, wrist and hand.

Falling on your back

At first glance, falling on your back seems safer. Indeed, the blow falls on the spine or pelvis area. The bones reliably protect the uterus from bruises.

However, there is less shock-absorbing fluid on the back side. This means that if a woman falls backward, the entire force of the blow will spread not only to the spine, but also deeper inside the body, without encountering any special obstacles along the way.

For an expectant mother, falling on her back poses a serious threat. Often such injuries occur in winter, during icy conditions. The result could be:

• Severe bruise of the back and lower back, hematomas in this area.
• Kidney bruise.
• Bruise or even subcapsular rupture of the spleen (with a very strong blow).
• Spinal fracture. This is possible with severe calcium deficiency and osteoporosis and is typical for late pregnancy.

Falling on your back has always been considered a serious injury; it requires a mandatory examination by a doctor to exclude unpleasant complications.

Falling on your side

Although falling during pregnancy is not a safe incident, when a woman lands on her side, the chances of harming the baby are minimal.

Of course, he will be injured, but it will be softened by amniotic fluid. In this position, the embryo is most protected by the surrounding membranes and internal organs.

However, the mother may be seriously harmed:

• If the elbow is involuntary, there is a high risk of breaking the arm.
• Falling on your side can lead to broken ribs and lung damage leading to pneumothorax. This becomes especially relevant in the later stages of pregnancy, when they are compressed by the uterus.
• If future mom falls on the right side and on an uneven surface, there is a possibility of liver damage. This is a life-threatening injury due to developing bleeding.
• A fall on the left side leads to injury to the spleen.

Of course, all of these serious injuries are possible if the woman was hit sideways with great force or if she fell, for example, onto rocks.

In a normal situation, if you fall on smooth asphalt, especially while wearing thick winter clothing, injuries are likely to be minimal.

However, no one canceled the fear in such a situation. Stress can be so strong for a woman that it can trigger a miscarriage, placental abruption, or the onset of premature labor. Therefore, you must be sure to control yourself and try not to be nervous.

Action tactics

The first thing an expectant mother should do if she falls is to carefully get up, preferably with someone's help, and calm down.

Anxiety and worries about the life and health of the baby will not help him in any way, and can cause very serious harm - both in the early and late stages of pregnancy.

If a woman feels severe pain in the abdomen, back or side, weakness, dizziness, trembling in the arms and legs, she should immediately call an ambulance. These symptoms may indicate serious damage internal organs or bleeding.

It is also necessary to do if the expectant mother notices that:

• The child began to move too actively or, conversely, suddenly calmed down.
• Painful growing contractions appeared.
• The amniotic fluid has receded.
• Bleeding from the genital tract began. Even a small amount of blood is a dangerous symptom.

The sooner a woman is hospitalized, the sooner she will receive the necessary assistance, including emergency delivery if necessary.

If the fall was not severe, and the woman does not notice any unpleasant sensations, it is better for her to go home and rest. However, during this or at least the next day, you must see your doctor.

Since any injury is easier to prevent than to treat, it is important to take certain precautions to avoid falls and consider risk factors.

Risk factors

In some situations, the likelihood of falling increases significantly. The following factors lead to increased risk:

• Wearing high-heeled shoes, especially stilettos, as well as slippery flat soles.
• Late pregnancy, when the center of gravity is shifted and gait is impaired.
• Inability to see an obstacle or pothole due to an enlarged abdomen.
• Sprain of the symphysis pubis, which leads to instability of this joint and a pronounced change in gait.
• Walking in icy conditions and snow or rain.

Prevention

Falls during pregnancy should be avoided at all costs. After all, even the most insignificant injury during pregnancy can result in serious complications.

First of all, you need to take care of comfortable shoes. During pregnancy, you should forget about high thin heels or platforms. Shoes should be comfortable and stable, but not flat. A low, wide heel is highly desirable.

Traumatologists and gynecologists do not recommend expectant mothers to go outside during bad weather. Snow, rain, and ice lead to increased trauma, which is especially dangerous in late pregnancy. If you can’t do without walking, you need to attach special anti-slip pads to the sole.

In the last weeks, expectant mothers need to move very carefully and, if possible, slowly. You should not run after vehicles or rush without looking at your feet. The smoother your gait, the lower the likelihood of falling and injuring your abdomen or back.

If the joints are unstable due to increased extensibility of the ligaments, it is better to follow a home regime.

If a fall is inevitable, you must try to land on your side, under no circumstances putting your hand forward.

Pregnancy is a special time. At this time, a woman should think not only about herself, but first of all try not to harm the child.

Anyone can lose their balance and fall, including a woman expecting a child. At first glance, it even seems that pregnant women have more reasons for this. But statistics show the opposite: pregnant women fall much less often than others simply because they are more careful. True, they do not immediately master this manner of behavior.

Causes of falls

In the first trimester, a fall is possible because the expectant mother has not yet adjusted to her new state and still strives to do everything quickly and without outside help. And she does not take into account that haste and excessive stress often become causes of falls, which are especially undesirable in her position. And from high heels, reducing resistance, the “beginner” pregnant woman is also not ready to refuse. Later she will become more careful, learn to avoid dangerous places and wear practical shoes. Hormonal changes, toxicosis and vascular spasms in the early stages of pregnancy sometimes provoke dizziness and fainting. To avoid the consequences of fainting, you need to learn to recognize its symptoms. Before loss of consciousness, there is suffocation, rapid heartbeat, legs become weak, beads of sweat appear on the forehead. If these changes are noticed in time, the consequences of the fall can be mitigated. It is recommended to stop, sit down or lean against the wall, and ask passers-by for help.

One step, two...

The easiest way to fall is from the stairs: you can lose your balance both when going up and when going down. The danger is increased not only by slippery steps and wobbly railings, but also by talking on a mobile phone. So from this " bad habit“It’s better to get rid of it.

Between 10 and 23 weeks pregnant women fall very rarely. Their body has already adapted to the changes, their condition has stabilized, and their worries have subsided. The woman has prepared herself for a long wait and is calmly going about her current affairs. After the 24th week, the hormonal background of a pregnant woman changes, and with it her mood. The expectant mother seems to wake up from sleep and begins to rapidly prepare a “nest” for the child. At this time, the family usually starts renovations and makes basic purchases for the baby. The pregnant woman actively participates in the process; it seems to her that nothing will happen without her. Very often, a husband, returning home after work, sees that his wife, standing on a chair, is trying to hang new curtains or tear off old wallpaper. This activity increases the risk of falling. The situation persists until 29–31 weeks of pregnancy. After this period, the hormonal levels level out, the woman becomes calmer.

According to statistics, 7% of women fall during pregnancy: 5% in the first trimester, 2% in the third. But when carrying twins or triplets, such a nuisance occurs much less frequently.

Defense Mechanisms

Natural mechanisms protect against serious consequences of falls. They work constantly and do not turn off during pregnancy. One of them - reflex relaxation of muscles during loss of consciousness - protects against miscarriage in the early stages of pregnancy, when the fertilized egg has not yet settled in the uterine cavity. During fainting, consciousness turns off, the muscles stop receiving impulses from the brain and relax, so the force of the blow is significantly reduced.

In the second and third trimesters, the placenta already firmly holds the fetus. It is surrounded by elastic cells of the uterus, which absorb shock as much as possible. And the fruit is “protected” amniotic fluid, membranes, pelvic bones and upper layer peritoneum.

By the 29th–31st week, all the baby’s life-supporting systems have been formed, all that remains is for him to gain the required weight and strength. The fetus begins to grow rapidly, and along with it, the belly of the expectant mother increases. And only thanks to the redistribution of the load does she manage to walk without losing balance or falling. In later stages, pregnant women walk leaning back. In this case, the center of gravity shifts from the middle spine to the sacrum, the distance between the feet increases, the knees bend more strongly and spring better - stability increases. But even with such “support”, caution must be exercised.

Consequences of falls

The consequences of falls during pregnancy are conventionally divided into two groups: some can cause harm to the child, others – to the woman herself. Danger to the fetus occurs only under extraordinary circumstances, such as a fall from a great height or a high-speed car collision. And the expectant mother is most likely to suffer the most common soft tissue bruises, dislocations, sprains, fractures and concussions. They bring a lot of serious worries. A concussion can cause vomiting, fractures can cause painful shock. But all these conditions do not affect the baby’s health in any way. Local anesthesia, which may be needed when applying a plaster cast to a complex fracture, will not harm him.

Due to a fall in the second trimester, a small vessel connecting the placenta to the uterus may be injured, which will lead to partial (non-progressive) placental abruption. This condition is always asymptomatic and does not affect the development of the fetus. The fact that it occurred at all will become known after birth by small blood clots on the placenta.

At a later stage of pregnancy (34–36 weeks), progressive placental abruption develops for the same reason. It provokes the onset of labor. With timely help, everything ends in childbirth and the birth of a healthy baby.

Action plan

Smooth landing

The consequences of hitting the floor, sidewalk or ground can be minimized by learning how to fall correctly. Already in the process of falling, you should at least slightly turn your body to the side in order to land on your side, then the likelihood of a fracture and concussion will decrease. When falling, you cannot put your legs and arms forward and bend them; they must lie flat on the ground, with their entire surface. Then the force of the impact will be distributed over a larger area, and a fracture will be avoided.

If a fall occurs, you need to act according to plan. Even if the impact force seemed insignificant, it is recommended to call “ ambulance" When you have the opportunity to stay in one place, you should take advantage of it and lie quietly for a minute or two, move your legs and arms, assessing your condition. There is nowhere to rush: everything has happened, and help is on the way. Even in winter, lying on the snow, there is no need to rush. In a couple of minutes, the body will not have time to become hypothermic, and the likelihood of getting sick is minimal. A sudden rise can cause your blood pressure to jump and make you feel dizzy. Therefore, it is recommended to get up slowly, preferably with the help of others. You should not listen to the advice of strangers - they most likely do not understand the situation well. You need to get to your feet from a comfortable position, without unnecessary muscle tension, for example from your knees. If you fall on your back, you should first sit down, leaning on your hands, and then, rearranging them, move to your knees. If you fall on your stomach, you must immediately turn on your side and from this position get on your knees.

The ambulance will bring the pregnant woman to the hospital, where she will be examined by several specialists: a therapist, a traumatologist and, of course, an obstetrician-gynecologist. If there are no fractures, dislocations or sprains, the examination by an obstetrician-gynecologist will be the longest. First, the doctor will listen to the child’s heartbeat, then ask about the nature of the fall, and find out if the stomach hurts. Then he will feel through the abdominal surface to see if the tone of the uterus has increased. If doubt arises, the examination will continue in the gynecological chair. The doctor will definitely notice that the cervix has shortened, as before childbirth. The last point of examination will be an ultrasound of the pelvic organs. If no violations are found during this examination, the expectant mother can be free. Fatigue and anxiety sometimes provoke fainting, so it is better to call a taxi or wait for relatives to arrive.

Homes with laminate floors and stairs are more likely to fall. Carpets and rugs only reduce risk if they are securely fastened

Learning to fall

Simple recommendations will help you avoid falls during pregnancy.

• There is no need to keep your hands in your pockets; you can use them to balance while walking. This makes it easier to maintain balance even on a slippery path. This skill will not hurt after pregnancy.
• It is better to leave your bag at home while walking; it interferes with balancing with your hands.
• In rain and ice, you should not go out alone. The support of the attendant will stop the fall.
• No need to take long steps.
• Purchases, even small ones, should be evenly distributed in the hands - this will increase stability.
• Slippery soles of shoes or boots will increase the risk of falling. Already when purchasing, you can determine whether the shoes will slip. If, after running your fingernail across the sole, a scratch remains, then reliable grip on the ground is ensured.
• When going up and down the stairs, you should hold on to the railing.
• Before you sit on a chair, you need to make sure that it is nearby. And if you move even a couple of centimeters, you might miss.
• You need to get up from the sofa, bed or table slowly to avoid dizziness.

The risk of falling during pregnancy increases with the length of pregnancy. There are several factors predisposing to this:

The expectant mother becomes somewhat clumsy due to her large belly, which limits her view: she cannot see what is under her feet. In addition to the increase in the abdomen, there is a fairly significant increase in weight (normally, during pregnancy, weight increases by 10–12 kg, and in a fairly short period of time), which makes it difficult to coordinate movements.

Due to the weight of the pregnant uterus, the center of gravity shifts anteriorly and the posture of the expectant mother changes - in the later stages of pregnancy, the so-called proud gait of pregnant women appears, when a woman walks with her tummy thrust forward, while tilting her spine back. This gait is an adaptive mechanism that allows you to mitigate the heavy load on the spine, but in some cases (slippery roads, wet floors, etc.) it can contribute to loss of balance.

The influence of hormones (for example, relaxin, which helps soften and prepare the cervix for childbirth) leads to structural changes not only in the genital organs, but also in the ligaments and joints (pelvis, hip joints), which soften due to increased water absorption, which can cause their mobility will change.

During pregnancy, quite significant changes occur in the central nervous system, when the “pregnancy dominant” is formed. At the same time, the excitability of the cerebral cortex decreases, inhibition processes become predominant (which is necessary to protect against unnecessary stress) and all vital interests are fixed on pregnancy and the upcoming birth. These physiological changes contribute to some absent-mindedness of the expectant mother, her absorption in her thoughts, which reduces the speed of reaction and increases the risk of falling during pregnancy.

Changes in the cardiovascular system, to which increased demands are placed even during a normal pregnancy, lead to an increased likelihood of low blood pressure, fainting, and a sudden deterioration in well-being, which can lead to a fall.

It must be said that not every fall by a pregnant woman can lead to adverse consequences for the pregnant woman or fetus. Nature provides reliable protection for the child in the womb from adverse external influences. The baby is in a connective tissue sac - the membranes, surrounded by amniotic fluid, the amount of which by the time of full-term pregnancy is 1-1.5 liters. Amniotic fluid has a shock-absorbing effect, protecting the fetus from damage. Therefore, if the expectant mother falls, then in the vast majority of cases the fetus will not be harmed. Adverse consequences of a fall by a pregnant woman can occur only in those rare cases when a direct traumatic effect is exerted directly on the pregnant uterus (a fall directly on the stomach, a car accident, an accident), and the risk of adverse consequences is directly proportional to the stage of pregnancy.

A fall during pregnancy can cause both obstetric complications (related to pregnancy and the condition of the fetus) and non-obstetric ones, which include bruises, fractures, sprains, injuries to internal organs, etc.

Obstetric complications that can be caused by a fall of a pregnant woman include premature placental abruption, threatened miscarriage, premature effusion amniotic fluid, fetal hypoxia.

Fall during pregnancy: premature placental abruption

One of the most dangerous complications for both mother and fetus in the event of an unsuccessful fall during pregnancy is premature abruption of a normally located placenta. Normally, the placenta separates from the wall of the uterus after the birth of the fetus. With a sharp blow to the abdominal area, the placenta can detach while the fetus is in the uterus, which is accompanied by internal bleeding, pain, and also causes hypoxia (lack of oxygen) of the fetus, in severe cases leading to its intrauterine death.

Direct abdominal trauma during pregnancy, as a rule, is a permissive factor, that is, the occurrence of premature placental abruption is preceded by a number of pathological conditions in a pregnant woman. Predisposing factors for the occurrence of placental abruption are diseases accompanied by increased blood pressure ( hypertonic disease, late gestosis, kidney diseases and of cardio-vascular system, endocrine diseases), pathology of the vascular wall, leading to its increased fragility and permeability.

The main symptoms of premature placental abruption are abdominal pain, uterine hypertonicity and the appearance of bloody discharge. Placental abruption can occur in two types - open (when the edge of the placenta separates from the wall of the uterus and blood is released out) and closed. In the latter case, separation of the placenta begins from the center, and the resulting retroplacental hematoma detaches the placenta from the uterine wall; the released blood accumulates between the wall of the uterus and the placenta and external bleeding may not be observed.

Fall during pregnancy: threat of miscarriage

For a pregnant woman, a fall, in addition to the direct traumatic impact, is also associated with fear, excitement, anxiety - that is, it causes stress. Similar combination unfavorable factors can lead to the appearance of symptoms of a threatened miscarriage, manifested by aching or cramping pain in the lower abdomen, increased tone of the uterus (when the uterus becomes hard, dense, as if “petrified” for a certain period of time), sometimes bloody discharge from the genital tract may appear in small quantity.

If the above symptoms appear, you should immediately consult a doctor, since timely treatment in the vast majority of cases helps to maintain pregnancy. To prevent pregnancy from being interrupted, tocolytics are prescribed - drugs that reduce the tone of the uterus (for example, magnesium sulfate), sedatives (motherwort, valerian, etc.), antispasmodics, as well as drugs that have a beneficial effect on the condition of the fetus.

Fall during pregnancy: premature rupture of amniotic fluid

A fall during pregnancy can lead to damage to the membranes and prenatal rupture of amniotic fluid. Normally, water should be poured out during childbirth, towards the end of the dilation period, since the amniotic sac, wedging into the uterine os with each contraction, helps the cervix to open.

Water can pour out quite abundantly (when the lower pole of the amniotic sac ruptures) - this moment is difficult not to notice, or it can leak gradually, in small portions, which is typical for a high rupture of the amniotic sac - in this case, you may notice the appearance of a small wet spot on the underwear.

If you have even a suspicion of leakage of amniotic fluid, you need to place a pad ironed on both sides with a hot iron cotton fabric(it is not advisable to use a simple pad in this case, since it absorbs discharge in such a way that it is quite difficult for a doctor to determine its nature) and be sure to consult a doctor. Currently, maternity hospitals have special test systems for diagnosing leakage of amniotic fluid, which make it possible to establish a diagnosis within a few minutes. If the rupture of amniotic fluid is not confirmed, you will be sent home. It is extremely important not to miss the moment when the amniotic fluid breaks, as this can facilitate the penetration of infection to the fetus.

If you feel that amniotic fluid has leaked, you need to call an ambulance, since this situation requires medical supervision exclusively in an obstetric hospital, and the development of labor management tactics depending on the specific case. Management tactics will depend on the duration of pregnancy (term or premature pregnancy), the condition of the fetus, and the presence of pathology in the mother that is an indication or contraindication for vaginal delivery.

Fall during pregnancy: fetal hypoxia

As mentioned above, a fall for a pregnant woman is almost always associated with stress to one degree or another, and the stress reaction leads to an increase in the level of hormones, primarily adrenaline. The release of stress hormones is a mandatory protective reaction of the body, leading to spasm (constriction) of blood vessels, including spasm of the blood vessels of the “mother-placenta-fetus” system. As a result of these physiological reactions, the delivery of nutrients and oxygen from mother to fetus can be significantly reduced and signs of intrauterine suffering of the fetus - hypoxia - appear.

Fetal hypoxia can manifest itself as an increase or, conversely, a sharp decrease in fetal motor activity. It must be said that in some cases, signs of hypoxia can only be recorded using special research methods - ultrasound, Doppler ultrasound (measurement of blood flow in the vessels of the uteroplacental basin), cardiotocography (registration of fetal cardiac activity), and obvious clinical signs of a violation of the intrauterine state of the fetus (on which the expectant mother may notice) may appear later.

Thus, if after a fall you feel pain in the abdomen, changes in the baby’s “behavior”, increased tone of the uterus, the appearance of unusual discharge from the genital tract, dizziness, severe weakness, you need to call an ambulance. To exclude dangerous complications, the doctor will conduct a vaginal examination on a gynecological chair to assess the nature of the vaginal discharge, the condition of the cervix (to exclude the threat of miscarriage) and the amniotic sac (to make sure that there is no rupture of amniotic fluid). In order to clarify how the baby is feeling, the doctor will listen to the fetal heart sounds, order an ultrasound examination and record a cardiotocogram.

Even if you feel fine and do not feel any pathological symptoms after the fall, in order to calm down and make sure that everything is fine with you and the baby, it is advisable to consult a doctor (it is acceptable to do this a few hours after the incident or the next day) , tell us about your fall and undergo the examinations that your doctor recommends.

Fall during pregnancy: non-obstetric complications

A fall during pregnancy can lead to various injuries - bruises, sprains, fractures. Common symptoms of traumatic injuries are pain (of varying intensity from moderate to very severe) at the site of the impact, tissue swelling, and difficulty moving in the area of ​​the injury. If such symptoms occur, you can apply ice to the injury site to relieve pain and reduce tissue swelling and consult a doctor immediately. Under no circumstances should you try to straighten the injured limb yourself, as this can significantly worsen the situation. If possible, try not to move the injured arm or leg.

A blow to the head causes a concussion, which may cause nausea, headache, short-term loss of consciousness, and disorientation.

In such cases, it is best to go to a multidisciplinary hospital, where, in addition to traumatology, surgery, neurology and other departments, there is a maternity hospital, in order, along with the injury, to promptly diagnose abnormalities during pregnancy and provide the necessary qualified assistance.

We provide security

During pregnancy, taking simple precautions will help you avoid trouble. So, what should you take care of to avoid falling?

First of all, your home should be safe - look for cables, wires and other objects lying on the floor under your feet, the danger of tripping over which increases in proportion to the stage of pregnancy.

All pregnant women sooner or later have an irresistible desire to arrange a room for the unborn baby, which is one of the characteristic signs of the so-called nesting syndrome. These aspirations are quite understandable, but be extremely careful: you do not need to climb onto a stepladder, chair, table, no matter how good you feel - ask your husband or relatives to help you.

It is very important to take care of comfortable and safe shoes: its heel should be no more than 3–4 cm high, the sole should have a stable anti-slip surface (sole winter shoes should be with deep corrugation or with a special tread coating). It is also important that the shoes provide good support not only for the foot, but also for the ankle, protecting the foot from twisting.

In unfavorable weather conditions (rain, snow, ice, etc.), it is best to stay at home. If you need to go somewhere, you need to do it only with an accompanying person (husband, girlfriend, mother). Choose the safest routes, avoiding hills, narrow paths, slippery paths, etc.

When going up and down stairs, hold the handrails tightly and look at your feet.

Some of the most dangerous places are the bathroom and swimming pool, because even in the absence of pregnancy, the risk of slipping on wet tiles is very high. To avoid troubles, it is advisable to place a non-slip rubber mat under your feet when taking a shower. When leaving the bathroom, be sure to find a foothold and hold on to it tightly. During the last months of pregnancy, it is best to take a shower or bath with someone close to you at home to help you get out of the bath. In the pool, be sure to wear non-slip, stable shoes, preferably ones that fit securely on your feet, as shoes such as flip-flops or slates can easily slip off your feet at the most inopportune moment. When leaving the pool, you need to hold on tightly to the handrails, and it is good if a person comes up after you who can pick up or support you if necessary.

If it happens that a fall cannot be avoided, it is very important that the pregnant woman falls “correctly.” At the moment of falling, you need to clasp your stomach with your hands and group yourself in such a way as to try to “sit” on your side, maximally protecting the pregnant uterus from impact. In no case should you put your arms forward and fall on your outstretched arms, as in this case you are almost guaranteed a fracture of the upper limbs. By following these recommendations, you can significantly reduce the risk of falling and protect yourself and your baby.

Lucky or not

With a favorable development of events, only a small part of the placenta may separate from the wall of the uterus when it falls, and the process will stop there - this is a non-progressive placental abruption. In this case, it is possible to continue pregnancy after a full examination (including laboratory methods, ultrasound examination of the fetoplacental complex, cardiotocography) under dynamic monitoring of the fetus’s condition, which is possible only in a hospital.

With progressive placental abruption (when the process of placental separation does not stop and the area of ​​placental abruption increases, fetal hypoxia increases, and disorders in the blood coagulation system occur), emergency delivery is necessary by caesarean section. The time factor in this situation plays a very important role for the outcome in relation to the mother and fetus, since the increase in blood loss occurs very, very quickly.

The expectant mother pays close attention to her belly. She tries to protect him from injury, realizing that this can lead to serious pathologies in the fetus. For this reason, a fall during pregnancy turns into a real tragedy and leads to a nervous breakdown. But is it really that dangerous?

to water leakage.

What to do if you fall?

If a fall during pregnancy does not affect your well-being, then there is no need to worry. You just need to listen to your body and your baby. A change in its activity should alert you and be a reason to consult a doctor. Also, the appearance of abdominal pain, brown discharge or leakage of water should not be ignored. But in any case, if a woman falls during pregnancy, she needs to see a doctor, even if feeling good. A specialist will conduct an examination to ensure there is no damage.

How to protect yourself from falls?

A pregnant woman in winter needs to glue special strips to the sole of her shoes that will protect her from slippery ice. Boots should only have small, stable heels. For clothing, it is recommended to wear long fur coats or down jackets that completely cover the stomach. If you fall, thick material will soften the blow. If possible, you should tie a fur scarf over your stomach. If the fall could not be avoided, then the woman should be able to group herself in such a way that the blow falls on her knees or side. You can put your hands up, but only both, to avoid a fracture. You cannot fall on your back, as well as on your stomach.

The topic of injury during pregnancy is unreasonably ignored by doctors, although in most cases such injuries can be prevented. After all, up to 20% of deaths of pregnant women occur due to injuries and damage not related to pregnancy.

Most often, women suffer injuries during pregnancy as a result of road traffic accidents (RTA). Fortunately, the incidence of pregnant women involved in road accidents, the degree of injury and the number of deaths do not exceed those of non-pregnant women.

Not inferior in frequency to road accidents are injuries associated with physical violence from a husband or partner and usually received at home. In developed countries, cases of injury as a result of physical violence occur in 5-30% of pregnant women, but still the majority of such incidents, especially with minor injuries, remain unpublicized and are not mentioned when visiting a doctor. In 64% of such cases, the woman receives blows to the abdominal area. Fetal death occurs in one out of 20 pregnant women.

In third place are falls and accidental injuries. As pregnancy progresses and the uterus grows, a woman’s center of gravity shifts, which leads to increased loss of balance. From 3 to 30% of falls are accompanied by injury, and the period after 32 weeks of pregnancy is especially dangerous.

Domestic and other types of injuries are rare in pregnant women, and the degree of damage is determined by the type of injury. The most dangerous are electric shocks, since more than 70% of such accidents result in the death of the fetus.

Despite the increased frequency of injuries to pregnant women, the consequences of injury during pregnancy for women’s health are less serious compared to injuries to non-pregnant women. Doctors explain this effect by the protective function of increased hormonal levels, as well as more frequent visits by pregnant women to medical institutions. Even with minor bruises and injuries, a pregnant woman is more likely to undergo a timely examination and receive the necessary help compared to other groups of people.

The extent of damage when injured depends on many factors. However, the duration of pregnancy plays a very important role. In the first trimester, while the uterus is within the pelvis, with blows, falls, or short-term compression of the abdomen, the risk of harm to the pregnancy will be minimal. Up to 3% of women who are injured and hospitalized due to it do not know that they are pregnant. The doctor is obliged to check with the woman, if her condition allows it, whether she is being protected from pregnancy and when she had her last menstruation. If menstruation is delayed, the hCG level is determined to determine the presence of pregnancy.

In the second trimester, the uterus already extends beyond the pelvis, but nevertheless, the fetus is surrounded by a sufficient amount of amniotic fluid, which softens the force of falls and blows, so the danger to the fetus in this period of pregnancy is also not too high.

In the third trimester and before childbirth, trauma can lead to premature birth, placental abruption, bleeding, uterine rupture, and intrauterine fetal death.

In the second half of pregnancy, if damage occurs, it is important where exactly the placenta is attached. Most often, the baby's place is located on the back wall of the uterus - this is one of nature's protective mechanisms. But in a number of women, the placenta is attached to the anterior wall of the uterus, which significantly increases the risk of placental abruption due to abdominal trauma. Special attention deserves abnormal attachment of the placenta - the so-called presentation, which in themselves can be accompanied by a number of complications, but with injuries these complications appear more often.

What should a pregnant woman do if she is injured as a result of a fall, accident, impact, etc.? To begin with, it is important to correctly assess the degree of harm to your own health and the health of the unborn child. Of course, the reaction of many women, especially in a state of shock, may be inadequate, so in such cases it is advisable to immediately contact a medical facility.

If the injury is not accompanied by pain, bleeding, or increased contractile activity of the uterus, the woman can lie down and monitor her condition and fetal movements, if she felt them before. It is important to remember that from the second half of pregnancy, an enlarged uterus can compress the inferior vena cava when the woman lies on her back, and this in 30% of cases is accompanied by unpleasant symptoms and creates a false picture of a worsening condition.

However, if you receive an injury, it is still undesirable to take any painkillers. If the impact of a fall or accident falls directly on the abdominal area and the woman experiences severe pain, it is necessary to call an ambulance or immediately go to the hospital on your own.

Up to 40% of pregnant women may experience increased uterine contractions after injury, but in 90% of cases these contractions will stop without negative consequences for pregnancy.

In a medical institution, the doctor is obliged to assess the woman’s condition and, if necessary, connect her to oxygen and intravenous drips. But it is very important to know the condition of the fetus, placenta, and amniotic fluid. In this case, ultrasound will be one of the best diagnostic methods. If the pregnancy is more than 23-25 ​​weeks, the woman may be sent to the maternity ward for observation, even with minor injuries.

Ultrasound allows you to determine not only the condition of the uterus, placenta, fetus, but also intra-abdominal bleeding. It is important to monitor the fetal heart rate: the mother's stress reaction can be reflected in the form of a stress reaction in the fetus. After 23-34 weeks of pregnancy, monitoring of the fetus and its activity is carried out for 4 hours, and if necessary, longer.

After injury, short-term disturbances in the fetal heart rhythm may be observed, but such deviations, as a rule, do not have a negative prognostic value. At the same time, a normal heart rhythm excludes a negative outcome of pregnancy due to injury.

Most types of examinations that are used in medicine to assess a patient's condition after injury are safe during pregnancy. Most often, women are concerned about the dangers of X-ray examination. Clinical studies show that x-rays of the pelvis, spine, and hips in the early stages of pregnancy (5-10 weeks) increase the rate of miscarriages and the occurrence of malformations. After 10 weeks, the effect of radiation is characterized by changes in the central nervous system of the fetus. The level of negative effects of radiation on the fetus depends on the radiation dose.

Computed tomography also carries an increased risk of radiation exposure, although to a lesser extent than x-rays. However, any type of examination that involves exposure to fetal radiation should be performed carefully and according to strict indications.

Very important question, which is often overlooked by both doctors and women, is the prevention of Rh sensitization, which is popularly called Rh conflict. All pregnant women from 6 weeks of pregnancy with a Rh-negative blood group after injury are recommended to administer 300 mg of anti-Rhesus antibodies (immunoglobulins), since in such cases damage to the placenta cannot be ruled out.

According to indications, tetanus prophylaxis should be carried out in injured pregnant women. This type of vaccine is safe for pregnancy.

In almost 30% of cases with moderate injuries and in more than 60% of cases with severe injuries, pregnancy will end in termination with loss of the fetus, while minor injuries will not affect the course of pregnancy and its outcome. Up to 20% of pregnant women requiring hospital treatment lose their pregnancies, since hospital treatment is usually required only in severe cases. However, even minor trauma doubles the risk of premature birth. Up to 7% of pregnant women require a cesarean section soon after injury.

Prevention of all types of injuries and damage in pregnant women is no different from that in other people. More attention is paid to the prevention of falls, so all women, starting from the second half of pregnancy, are recommended to wear low-heeled shoes, be extra careful when using stairs, limit sudden movements, as well as physical activity that is accompanied by a high risk of falling (biking, skating, skiing, horse riding, jumping, running, etc.). When in transport, with the exception of public transport, a pregnant woman must wear seat belts. Physical violence and abuse of power must be promptly identified and suppressed by all appropriate measures, including the intervention of law enforcement agencies, social services, family counselors and other professionals.

In general, minor injuries do not have an adverse effect on pregnancy, and the woman calmly gives birth to a healthy, full-term baby.