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Case Reports
. 2023 Sep;36(3):281-285.
doi: 10.20408/jti.2022.0070. Epub 2023 Jan 18.

Ruptured uterus in a 36-week pregnant patient with hemorrhagic shock after blunt trauma in Korea: a case report

Sebeom Jeon  1 , Suyoung Park  2 , Soohyun Oh  3 , Jayun Cho  1
Affiliations
Case Reports

Ruptured uterus in a 36-week pregnant patient with hemorrhagic shock after blunt trauma in Korea: a case report

Sebeom Jeon et al. J Trauma Inj. 2023 Sep.

Abstract

Traumatic uterine rupture is uncommon but can be fatal and life-threatening for both the mother and infant. In addition to complications caused by trauma itself, such as pelvic fracture, gestational complications such as placental abruption, abortion, premature labor, rupture of membranes, maternal death, and stillbirth can occur. In particular, fetuses have been reported to have a high mortality rate in cases of traumatic uterine rupture. A 35-year-old pregnant female patient fell from the fourth floor and was admitted to our trauma center. We observed large hemoperitoneum, pelvic fractures, and spleen laceration, and the fetus was presumed to be located outside the uterus. The pregnant woman was hemodynamically unstable. Although the fetus was stillborn, angioembolization and surgical treatment were properly performed through collaboration with an interventional radiologist, obstetrician, and trauma surgeons. After two orthopedic operations, the patient was discharged after 34 days. This case report suggests the importance of a multidisciplinary approach in the treatment of pregnant trauma patients.

Keywords: Blunt injuries; Case reports; Interdisciplinary studies; Stillbirth; Uterine rupture.

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Conflict of interest statement

Conflicts of interest Jayun Cho serves on the Editorial Board of Journal of Trauma and Injury, but was not involved in the peer reviewer selection, evaluation, or decision process of this article. The authors have no other conflicts of interest to declare.

Figures

Fig. 1.
Fig. 1.
Computed tomography. (A) An axial view shows hemoperitoneum (black arrow) and spleen laceration (white arrow). (B) A coronal view shows the fetus (black arrowhead) located in the peritoneal cavity and the disrupted wall of uterine fundus (white arrowhead).
Fig. 2.
Fig. 2.
Bilateral iliac arteriography reveals mild hypertrophy of the bilateral uterine arteries (arrows), which were embolized using (A) gelatin sponge particles for the right uterine artery and (B) N-butyl-cyanoacrylate for the left uterine artery.
Fig. 3.
Fig. 3.
Images showing (A) the stillborn fetus located in the abdominal cavity outside the uterus (arrow) and (B) the ruptured uterus (arrowhead).
Fig. 4.
Fig. 4.
Images showing (A) the uterus repaired by an obstetrician and (B) the placenta separated from the pregnant woman.
See this image and copyright information in PMC

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