An electrical injury, commonly called electrocution, occurs when an electrical current passes through the body, causing tissue damage. During pregnancy, this event presents a complex medical challenge because the current can affect both the pregnant person and the developing fetus. Even a seemingly minor shock can be serious, as external injuries may not reflect hidden internal damage to organs or the pregnancy unit. Understanding the mechanisms of this injury and the specific risks involved is the first step in seeking appropriate and timely medical care.
How Electrical Current Affects the Body
The severity of an electrical injury is determined by several physical factors, including the voltage, type of current, duration of contact, and the specific pathway the current travels. Low-voltage alternating current (AC), common in home settings (110-220 volts), is particularly dangerous because it causes continuous muscle contraction, prolonging contact time and increasing the total energy delivered. The human body acts as a conductor, and the current seeks the path of least resistance between the point of entry and the point of exit. Dry skin offers high resistance, but wet skin significantly reduces resistance, allowing more current to flow deeper into the body.
The path the current takes is a major determinant of injury, with a vertical flow (hand-to-foot or head-to-foot) being the most hazardous. This vertical path directs the current through the core of the body, including the chest and abdomen. Inside the pregnant person’s abdomen, the amniotic fluid and surrounding tissues are highly conductive due to their high water and electrolyte content. This effectively channels the current toward the uterus, placenta, and the fetus, bypassing some protective maternal tissue resistance.
Direct Risks to the Pregnant Person
The immediate risks to the pregnant person relate to the current’s effect on muscle and nerve function. Current passing through the chest can disrupt the heart’s natural electrical rhythm, leading to cardiac arrhythmias or even immediate cardiac arrest. Low-frequency alternating current is known for its ability to induce ventricular fibrillation, a life-threatening, chaotic heart rhythm. This effect is independent of the external appearance of the injury, meaning internal cardiac damage can occur without significant external burns.
The current can cause severe thermal injuries, resulting in deep internal burns along the path of the current flow, often disproportionate to the small entry and exit wounds on the skin. The heat generated by electrical resistance can cause necrosis, or tissue death, in muscles, nerves, and blood vessels. Significant muscle damage can lead to a condition called rhabdomyolysis, where damaged muscle fibers release proteins into the bloodstream. These proteins can damage the kidneys, potentially causing acute kidney failure if not treated immediately with aggressive fluid therapy.
Specific Concerns for Fetal Health
The fetus is uniquely vulnerable to electrical injury, and the severity of the mother’s injuries does not reliably predict the outcome for the baby. The low resistance of the amniotic fluid and the fetal skin means a significant amount of current can reach the fetus. The current may cause direct thermal injury to fetal tissues or disrupt the fetal heart’s rhythm, similar to the risk for the mother. Fetal cardiac arrest or direct neurological damage are potential complications, particularly with a current pathway that involves the uterus.
The most common serious complication specific to the pregnancy unit following electrical shock is placental abruption, the premature separation of the placenta from the uterine wall. The electrical current can cause intense, involuntary contractions of the uterine muscle or lead to vascular damage in the placental bed, resulting in this separation. Placental abruption causes severe hemorrhage, depriving the fetus of oxygen and nutrients, often requiring immediate delivery or leading to fetal death.
Even if the fetus survives the initial insult, the shock can trigger uterine irritability, increasing the risk of miscarriage in early pregnancy or preterm labor in later stages. The current may also cause placental damage that is not immediately apparent, leading to long-term issues such as intrauterine growth restriction or oligohydramnios (low volume of amniotic fluid). A pregnant person who experiences an electric shock is always monitored closely for signs of these delayed complications, highlighting the unpredictable nature of the injury.
Required Medical Evaluation and Monitoring
Any pregnant person who has experienced an electrical shock requires immediate and comprehensive medical evaluation. The initial assessment focuses on stabilizing the mother, including a thorough check of vital signs and a cardiac evaluation. An electrocardiogram (ECG) is mandatory to check for immediate or delayed signs of cardiac conduction abnormalities or arrhythmias. Blood tests are also performed to look for markers of internal injury, such as elevated levels of Creatine Phosphokinase (CPK), which signals muscle damage and the potential for rhabdomyolysis.
Following maternal stabilization, the focus shifts to fetal assessment and monitoring. For pregnancies beyond 20 weeks of gestation, continuous fetal heart rate monitoring, typically using cardiotocography (CTG), is the standard protocol. This monitoring is often continued for a minimum of four to six hours, even if the mother appears stable and the initial fetal assessment is reassuring. The goal of this extended monitoring is to detect subtle signs of uterine contractions or changes in the fetal heart rate pattern that might signal an underlying placental abruption or fetal distress.
If the initial evaluation and monitoring are normal, the pregnant person may be discharged with clear instructions for close follow-up. They must report any changes in fetal movement, vaginal bleeding, or abdominal pain. If any signs of maternal injury, uterine contractions, or non-reassuring fetal status are detected, the pregnant person will be admitted for further observation and specialized care. The unpredictability of the fetal outcome makes this structured, multi-hour monitoring period a necessary part of the management protocol.