The pregnant trauma patient presents unique diagnostic and management issues for the emergency physician and trauma surgeon. Maternal shock carries a high fetal mortality rate. Although there are two lives at stake, proper assessment and stabilization of the mother will provide the best opportunity for fetal stability. Therefore, rapid assessment of the pregnant trauma patient is essential for early identification of life-threatening injuries. The FAST examination clearly plays a role in the timely assessment of pregnant trauma patients. [22][23][24] In this setting, ultrasonography offers several advantages over abdominal CT scan and diagnostic peritoneal lavage. The FAST examination may aid in the timely identification of pregnant trauma patients who need exploratory laparotomy immediately and may help avoid delays in management while other diagnostic tests are obtained. The FAST examination can be performed at the bedside and involves no contrast material or radiation exposure to the mother or fetus. Sonography can rapidly assess the pregnant trauma patient for hemoperitoneum and intrathoracic hemorrhage and can assess the fetus for fetal heart tones, activity, and approximate gestational age. Although ultrasonography is useful for identifying fetal heart tones and fetal movement, it is not as accurate in diagnosing uterine rupture or placental abruption, and it may be more technically difficult for advanced third trimester pregnancy. 25 The identification of free intraperitoneal fluid may be related to hemorrhage from solid organ injuries or amniotic fluid from uterine rupture, or both. Ultrasonography should not be considered a reliable method for the specific identification of uterine rupture. The presence of an intrauterine organized hematoma and/or oligohydramnios, however, may suggest this diagnosis. Finally, although ultrasonography can be utilized to confirm immediate fetal viability, it cannot be used to rule out fetal-placental injury. Although ultrasonography is used as an adjunct for diagnosis of placental abruption, it is not sufficiently sensitive to exclude this diagnosis. 25 Continuous cardiotocographic monitoring, which has been demonstrated to accurately detect significant placental abruption, should be utilized as early as possible for all pregnant patients with significant blunt trauma. 26 