Oops, Balance Loss and Minor Falls in Early Pregnancy

Balance in pregnancy changes, and it changes every few weeks. Between the posture changes, and the center of gravity changes, and the weight gain, even eyesight changes (but in some studies is actually better), changes in hearing in all individuals can affect balance, moms have lots of challenges to being upright all of the time! And occasionally you will slip and fall, in spite of being very careful not to when you are pregnant. So gynos will often have to check a mom for falls and accidents. If you have had a major accident , for instance a car accident, while pregnant, this is a serious concern, and you need emergency room evaluation in a setting that can handle high risk pregnancies. A minor fall is a very different kind of event, but still one that should make you contact your prenatal care provider. If  you have severe pain or bleeding, that is an emergency. If you are sore and just have some bruises, it's time to get in for a check up, no matter how far into your pregnancy you are. Most often you will just need a brief exam and ultrasound, but sometimes other tests even x-rays are needed to check on you after a fall. If you are suggested to get an x-ray, it's important to remember that we need to take good care of mom first, as she is the caretaker of the baby. So if you need an x-ray, then you should get one. X-rays are important to withhold in a pregnant patient if they are unnecessary. If you have had a simple fall whether on your abdomen or not, it’s important to check both you and the baby. The fluid around the baby is an important cushion against minor injury and most cases of simple falls do not translate into fetal harm. The average “Cat Scan” “CT” is on the order of 2 to 2.5 rads, and the American Congress of Obstetricians and Gynecologists in their 1998 bulletin has said that babies can tolerate 5 to 10 rads of exposure. There are blood tests, not particularly accurate to say if there has been baby's blood leaking through the placenta's blood passageways into mom's blood stream. The test we use is Kleihauer-Betke, and it is used after deliveries to calculate Rhogam dosing in some hospitals. After falls it can also help calculate how much Rhogam an Rh negative mom might need if her providers think she needs an extra shot. Once mom's get into the late second and third trimester, if they have an accident or a fall it will be up to your obstetrician to determine the course of action. In many cases after a fall the mom is often put on the fetal heart rate and contraction monitor to check on the health of the baby, and ultrasound may be used to check the length of the cervix. If no contractions or leaking for an hour, most studies will say the pregnancy is stable. You are designed to protect your baby, but if you fall, it's good to double check!

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