| Autor: |
Ahmad, Irshad, Uniyal, Madhur, Chawla, Latika, Ahmad, Sameer, Jagne, Nilesh, Yadav, Ankita |
| Předmět: |
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| Zdroj: |
Indian Journal of Surgery; Jun2024, Vol. 86 Issue 3, p618-621, 4p |
| Abstrakt: |
Trauma is the leading cause of non-obstetric maternal mortality and contributes to around 20% cases of maternal deaths. The commonest cause of trauma during pregnancy is road traffic accidents. An 18-year-old G2 P1 L1 at 13 weeks of gestation living in a makeshift tent near a construction site came under a landslide. She remained buried under the rubbles until she could be excavated next day. Patient reached our facility almost 27 h after the incident. Primary survey revealed patent airway; however, she had tachypnea, tachycardia and hypotension, positive FAST examination, and fetus floating in fluid filled peritoneal cavity on USG abdomen. Patient was resuscitated and immediately taken for exploration, which revealed hemoperitoneum, uterine fundus perforation with decapitated fetus in the peritoneal cavity, two jejunal perforations, and tear in urinary bladder wall and anterior vaginal wall. Primary repair of jejunal and uterine perforations with suprapubic cystostomy (SPC) was followed by repair of the anterior vaginal wall at a later stage. Patient was discharged in healthy condition and is doing well on follow-up. Management of trauma in pregnancy is challenging due to physiological changes and involves concurrent resuscitation of two patients. The uterus remains an intra-pelvic organ until 12–14 weeks of gestation and is protected by the pelvic skeleton. The incidence of rupture of scarred uterus is between 0.3 and 1 % and that of unscarred uterus is 1 in 5700 to 1 in 20,000 pregnancies. Almost all of these ruptures occur in 3rd trimester near term. Traumatic uterine rupture is reported to have almost 100% fetal and 46% maternal mortality. Uterine trauma with fetal demise is more common in the late second and third trimester and placental abruption being leading cause of fetal death in such cases. Traumatic uterine rupture in first trimester is extremely rare. Traumatic uterine rupture with fetal decapitation in early pregnancy has not been reported to best of our knowledge. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
| Externí odkaz: |
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