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经阴道穿透性胎儿头部损伤

[Transvaginal penetrating fetal head injury].

作者信息

Moscote Salazar Luis Rafael, Alcalá-Cerra Gabriel, Castellar Leones Sandra Milena, Gutiérrez Paternina Juan José

机构信息

Servicio de Neurocirugía, Hospital San Rafael, San Juan del César, Colombia.

出版信息

Arch Argent Pediatr. 2012 Oct;110(5):e99-e102. doi: 10.5546/aap.2012.e99.

Abstract

In utero head traumas are extremely rare and are usually caused by penetrating injuries in the thoracic or abdominal wall that affect the uterine cavity. Transvaginal fetal head injuries have been reported in exceptional cases. This is a case-report of a fetus affected by penetrating head trauma with skull fracture and intra-ventricular hemorrhage after his mother's self-insertion of a blunt object, violently through the vagina. Trauma disrupted the integrity of intrauterine membranes and precipitated preterm labor. After birth, there was a debridement of the scalp and surgical management of the fracture was performed; nevertheless, the patient died four weeks later, due to neonatal sepsis. Management of these wounds must not only be focused on repairing the primary wound, but on preventing the infectious complications.

摘要

子宫内头部创伤极为罕见,通常由影响子宫腔的胸壁或腹壁穿透伤引起。经阴道的胎儿头部损伤在个别病例中有报道。本文报告一例胎儿因母亲经阴道暴力自行插入钝器导致穿透性头部创伤、颅骨骨折和脑室内出血的病例。创伤破坏了羊膜的完整性并引发早产。出生后,对头皮进行了清创,并对骨折进行了手术处理;然而,患者四周后因新生儿败血症死亡。这些伤口的处理不仅要着重修复原发伤口,还要预防感染并发症。

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