Case report: lethal fetal head injury and placental abruption in a pregnant trauma patient

Abstract

Fetal trauma in blunt abdominal trauma is uncommon, but traumatic fetal head injury is almost universally fatal to the fetus. Placental abruption is the most common injury to the gravid uterus in trauma, and when the mother survives, it is the most common cause of fetal death. The imaging diagnosis of these conditions may be difficult since there are only three cases reported in the literature of intrauterine skull fractures on plain films [3, 8, 10], ultrasound is in sensitive in the diagnosis of placental abruption [24], and the most sensitive test to diagnose placental abruption is external fetal monitoring with devices that measure uterine tone and contractility and fetal heart rate [23]. The diagnosis of fetal trauma and placental abruption may be made on contrast enhanced CT performed through the abdomen and pelvis of pregnant trauma patients. For these reasons, it is useful for the radiologist interpreting the CT scan to recognize fetal head injuries and placental abruption in pregnant trauma patients.Fig. 7 Axial scans through the bony pelvis demonstrate an unstable pelvic fracture with posterior pelvic ring disruption.There is a zone 2 fracture of the left sacrum and a fracture of the left obturator ring (arrowheads)