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At least 109 records · Page 6Linked to original sources
PubMed1991

[Pregnancy and traffic accident. A case report].

The authors report the case of patient (second pregnancy, first birth) who had been involved in a traffic accident which occurred on October 5, 1989 after 7 months of pregnancy. The trauma was scored 2 on the international Overall Abbreviated Injury Scale. The impact was frontal and the patient driving and wearing her seatbelt. After being admitted to hospital on several occasions with metrorrhagia and uterine contractions, it was decided to carry out a cesarian and a baby was successfully removed. The child presented with angulation of the left fore-arm and skeletal X-ray, particularly of the arms, revealed a fracture line with a callous already formed.

Accidents, Traffic↗
PubMed1989

Multiple uterine rupture and crushing injury of the fetal skull after blunt maternal trauma. A case report.

Multiple pelvic fractures and explosive-type uterine lacerations occurred in a previously healthy 17-year-old primigravida involved in a motor vehicle accident. The fetus suffered a crushed skull and was completely extruded with the placenta from the uterus. Treatment was complicated by severe disseminated intravascular coagulation with secondary fibrinolysis. Thrombelastography enabled us to rapidly evaluate the patient's coagulation status and to monitor her response to goal-directed therapeutic interventions (surgery, specific blood product therapy and epsilon-aminocaproic acid).

Accidents, Traffic↗
PubMed2004

Diagnostic mid trimester amniocentesis: how safe?

OBJECTIVE: Genetic mid-trimester amniocentesis is a common invasive procedure. The origin of the commonly quoted 0.5% rate of procedure-related pregnancy loss after amniocentesis is obscure and is in conflict with the only randomized prospective study that reported a procedure-related rate of loss of 1.0%. This review was performed to establish an estimate of procedure-related pregnancy loss after mid-trimester amniocentesis. The impact of placental puncture on the rate of loss and the risk of direct needle injury to the fetus were also examined. STUDY DESIGN: The National Library of Medicine database was used to identify English language reports of >1000 amniocenteses with sufficient detail and follow up data to allow the calculation of the rate of spontaneous pregnancy loss after amniocentesis but before 28 completed weeks. These reports were divided into 2 groups to assess the impact of the ultrasound technique. Group I described only preamniocentesis ultrasound evaluation; group II described primarily concurrent ultrasound needle guidance. Pregnancy loss between the 2 groups was compared. The impact of placental puncture and reported direct fetal trauma were examined. The significance of differences was tested using chi-square analysis, with significance at a probability value of < or =.05. RESULTS: Twenty-nine reports that totaled 68,119 amniocenteses were examined. In a comparison of all studies in group I with all studies in group II, there was a lower rate of loss after amniocenteses with the use of concurrent guidance (1.4%) compared with the use of preamniocentesis ultrasound evaluation (2.1%) that was significant ( P <.001). Among only the 5 controlled studies that used preamniocentesis ultrasound evaluation, the difference in rate of loss between amniocentesis patients and control subjects was 0.6% ( P =.0042; 95% CI, 0.19, 1.03), which was identical to the difference in the rate of loss of 0.6% between amniocentesis patients and control subjects from the 5 controlled studies that used concurrent ultrasound needle guidance ( P <.0001; 95% CI, 0.31, 0.90). Multiple case reports and small series of presumed fetal needle trauma were reviewed, but most of these attributed causation to the amniocentesis needle based only on circumstantial association. Two cases with direct evidence of fetal needle trauma are discussed. Finally, the rate of loss after placental puncture from among 9 reports that provided this detail was 1.4% and not different from the overall rate of loss that was noted in group II. CONCLUSION: This examination of experience with 68,119 amniocenteses from both controlled and uncontrolled studies provides a substantive basis for several conclusions: (1) Contemporary amniocentesis with concurrent ultrasound guidance in controlled studies appears to be associated with a procedure-related rate of excess pregnancy loss of 0.6% (95% CI, 0.31, 0.90). To determine the total rate of loss, this must be added to the reported natural rate of loss without amniocentesis among control patients of 1.08%. (2) The use of concurrent ultrasound guidance appears to reduce the number of punctures and the incidence of bloody fluid. Concurrent ultrasound guidance was associated with a reduced rate of loss when all studies were compared, but not among controlled studies. (3) Direct fetal needle trauma is rare, and rarely proved, but may occur more frequently than is reported because of a failure to diagnose and a failure of the consistent production of sequelae. (4) This experience does not substantiate an increased rate of pregnancy loss if placental puncture is required.

Abortion, Spontaneous↗
PubMed1977

Amyotrophic lateral sclerosis in dizygotic twins.

A pair of dizygotic twins developed typical amyotrophic lateral sclerosis during adulthood. The concordance for this disease in these two patients of nonconsanguineous parentage with no family history of the disorder suggests the possibility of sublethal intrauterine injury to anterior horn cells. Infectious or toxic exposure during the twins' intimately shared milieu in the prenatal period could have resulted in a neuronal "abiotrophy" that would not have become clinically apparent until decades later. If such a prenatal neuronal injury plays a role in the pathogenesis of amyotrophic lateral sclerosis, it becomes clear that attempts at experimental animal transmission of the disease from affected adults would fail even if the offending agent were viral.

Amyotrophic Lateral Sclerosis↗
PubMed1997

Severe malformation of one foot from amniocentesis needle injury.

An 11-year-old boy is described who was born with a poorly developed right foot. At 16 weeks gestation his mother had had amniocentesis without direct ultrasound guidance. After the insertion of the amniocentesis needle, she felt strong abdominal resistance, which disappeared with slight withdrawal of the needle. Then, real-time ultrasound was used to determine the position of the needle, which was reported to be up against the feet. Nine days later deep purple amniotic fluid was removed by amniocentesis. At birth there was a scab over an oozing hole in the lateral aspect of his right 'foot', a poorly formed structure with five digit-like structures at the tip. It seems most likely that the deformity was caused by tissue injury from needle puncture at 16 weeks gestation.

Adult↗
PubMed1973

Antenatal injury.

Explore the source record for details and available documents.

Abnormalities, Drug-Induced↗
PubMed1990

Gunshot wounds to the gravid uterus. A case report.

A pregnant woman sustained an abdominal gunshot wound during the second trimester; the bullet injured multiple loops of bowel and passed through the uterus, placenta and fetus. Although the stillborn fetus was delivered by cesarean section, a review of the literature indicated that operative delivery is not indicated when the fetus has died already. Labor and delivery are well tolerated, and an unnecessary hysterotomy is thus avoided. If labor does not ensue spontaneously, it can be induced. Approximately 40% of fetuses will survive the initial injury. In past reviews the risk of prematurity often outweighed the benefits of delivery of those infants. Advances in neonatology now make survival routine after 28 weeks' gestation, and viable fetuses should be delivered promptly by cesarean section to decrease the risk of delayed death from fetal or placental injury.

Adult↗
PubMed2004

Accidental fetal lacerations during cesarean delivery: experience in an Italian level III university hospital.

OBJECTIVE: The purpose of this study was to investigate the incidence, type, location, and risk factors of accidental fetal lacerations during cesarean delivery. STUDY DESIGN: Total deliveries, cesarean deliveries, and neonatal records for documented accidental fetal lacerations were reviewed retrospectively in our level III university hospital. The gestational age, the presenting part of the fetus, the cesarean delivery indication, the type of incision, and the surgeon who performed the procedure were recorded. Cesarean deliveries were divided into scheduled, unscheduled, and emergency procedures. Fetal lacerations were divided into mild, moderate, and severe. Neonatal follow-up examinations regarding laceration sequelae were available for 6 months. RESULTS: Of 14926 deliveries, 3108 women were delivered by cesarean birth (20.82%). Neonatal records documented 97 accidental fetal lacerations. Of these accidental lacerations, 94 were mild; 2 were moderate, and 1 was severe. The overall rate of accidental fetal laceration per cesarean delivery was 3.12%; the accidental laceration rate in the cohort of fetuses was 2.46%. The crude odds ratios were 0.34 for scheduled procedures, 0.57 for unscheduled procedures, and 1.7 for emergency procedures. The risk for fetal accidental lacerations was higher in fetuses who underwent emergency cesarean birth and lower for unscheduled and scheduled cesarean births (P < .001). CONCLUSION: Fetal accidental laceration may occur during cesarean delivery; the incidence is significantly higher during emergency cesarean delivery compared with elective procedures. The patient should be counseled about the occurrence of fetal laceration during cesarean delivery to avoid litigation.

Cesarean Section↗