Rib fractures with heamothorax after labor: a case report

Vasileios K Kouritas,Nikolaos Desimonas,Kostas Hatzitheofilou,Alexandros Daponte,Maria Kouvaraki,Ioannis Baloyiannis

doi:10.4076/1757-1626-2-8950

Abstract

IntroductionMaternal thoracic trauma during labor is extremely rare.Case presentationA woman was presented at the Accident and Emergency Department complaining of pain over the lower thorax bilaterally which started after a difficult delivery when the obstetrician forced her lower thorax. Small right-sided haemothorax and rib fractures bilaterally were diagnosed and she was admitted to hospital. Her in-hospital stay and follow up was uneventful.ConclusionManeuvers during labor should be applied from trained personnel and should be performed safely.

Highlights

Maternal thoracic trauma during labor is extremely rare
Case presentation: A woman was presented at the Accident and Emergency Department complaining of pain over the lower thorax bilaterally which started after a difficult delivery when the obstetrician forced her lower thorax
It is known that a complicated delivery can be due to different reasons such as abnormal infant position, shoulder dystokia etc

Summary

Introduction

It is known that a complicated delivery can be due to different reasons such as abnormal infant position, shoulder dystokia etc. In order to deliver the infant, the obstetrician or perinatal personnel may apply different kinds of maneuvers i.e. the fundal pressure in an effort to avoid the possibility of transforming the delivery to cesarean section [1]. We present an unusual case of bilateral thoracic trauma (rib fractures) and small right-sided heamothorax occurred by an attempted maneuver application during labor. Chest X-ray revealed a small right-sided haemothorax (Figure 1). Rib cage X-rays were performed, that revealed 8th and 9th rib fractures of the right hemithorax (Figure 2) and 9th to 11th rib fractures of the left hemithorax. She was discharged on painkillers two days later and referred to the outpatient department in for further follow up. The patient’s pain subsided while the haemothorax was observed to resolve on her follow up chest x-ray fifteen days later (Figure 3)

Discussion

Conclusion

Cosner KR

Findings

Zimmermann T