Sadro Claudia T, Zins Andrea M, Debiec Kate, Robinson Jeffrey
Department of Radiology, Harborview Medical Center, Seattle, WA 98104-2499, USA.
Emerg Radiol. 2012 Apr;19(2):175-80. doi: 10.1007/s10140-011-1017-9. Epub 2012 Jan 12.
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)
钝性腹部创伤中的胎儿创伤并不常见，但创伤性胎儿头部损伤对胎儿几乎普遍是致命的。胎盘早剥是创伤中妊娠子宫最常见的损伤，当母亲存活时，它是胎儿死亡的最常见原因。这些情况的影像学诊断可能很困难，因为文献中仅报道了3例平片显示宫内颅骨骨折的病例[3,8,10]，超声对胎盘早剥的诊断不敏感[24]，而诊断胎盘早剥最敏感的检查是使用测量子宫张力、收缩力和胎儿心率的设备进行外部胎儿监测[23]。胎儿创伤和胎盘早剥的诊断可通过对妊娠创伤患者的腹部和骨盆进行对比增强CT来做出。由于这些原因，对于解读CT扫描的放射科医生来说，识别妊娠创伤患者的胎儿头部损伤和胎盘早剥很有用。图7 通过骨盆的轴位扫描显示骨盆骨折不稳定，伴有骨盆后环破坏。左侧骶骨有2区骨折，左侧闭孔环骨折（箭头）
