This study aimed to understand the mechanisms of lesions that occur in pregnant women involved in automobile accidents, their outcomes, and to evaluate the effectiveness and reliability in the use of existing seatbelts.A systematic review was conducted based on PubMed, Scielo, and Lilacs.Describers: Pregnancy, traffic accidents, pregnancy complications, seatbelts, protective devices.Criteria of inclusion: Articles published in the period from 2006 to 2017, in the English, Portuguese, or Spanish languages.Eight studies were selected that comprised the sample in this research.The findings indicate that the main mechanisms of lesions that occur in pregnancy due to an automobile accident are related to direct trauma on the abdomen, given that at the moment of an accident the objects located within the vehicle continue moving forw ard, causing the pregnant woman to project the torso forward, strongly compromising the uterus, even with the use of the subabdominal seatbelt; despite this, the majority of the authors relate that the non -use of the seatbelts could lead to even graver traumatisms, including adverse fetal consequences.