Kleihauer-Betke testing accurately predicts the risk of preterm labor after maternal trauma. Clinical assessment does not. With a negative KB test, posttrauma electronic fetal monitoring duration may be limited safely. With a positive KB test, the significant risk of PTL mandates detailed monitoring. KB testing has important advantages to all maternal trauma victims, regardless of Rh status.
The maternal respiratory tract undergoes significant anatomic and physiologic changes during pregnancy, which increase maternal susceptibility to respiratory failure. Respiratory failure in pregnancy is relatively rare, but it remains one of the leading conditions requiring intensive care unit admission in pregnancy and carries a high risk of maternal and fetal morbidity and mortality. Acute respiratory failure can result from a variety of conditions, most of which are not pulmonary in origin. Early diagnosis of underlying disease is critical, as it will guide the management approach. Treatment goals during respiratory failure in the pregnant woman are similar to those outside of pregnancy-to maintain adequate ventilation and to provide hemodynamic and nutritional support. Additionally, the obstetrician will need to monitor fetal status and help to determine the best timing for delivery.
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