Aserlind Alexandra B, Burnweit Cathy A
Department of Obstetrics and Gynecology, University of Miami Miller School of Medicine, USA.
Department of Pediatric Surgery, Nicklaus Children's Hospital, Miami, Florida, USA.
Case Rep Womens Health. 2020 May 5;27:e00213. doi: 10.1016/j.crwh.2020.e00213. eCollection 2020 Jul.
This case raises awareness of the diagnosis of sternal fracture during labor and obviates the need for lengthy, expense-consuming workup. This report identifies a subset of women who may be at higher risk for this pathology.
Upon diagnosing and treating a patient who spontaneously fractured her sternum during labor, we reviewed previously reported cases and highlight key points of this entity.
We report the third case of sternal fracture during labor in a healthy primigravida with female athlete triad. After 12 h of labor, the woman underwent epidural placement. By 16 h, the cervix was fully dilated. During the second push in the chin-to-chest position, a healthy baby was delivered, but the mother experienced acute anterior chest pain. Tenderness persisted for three weeks. Plain radiographs confirmed the presence of the fracture, which healed spontaneously.
While chest pain during labor often results from serious causes including pulmonary embolism, myocardial infarction, and spontaneous pneumothorax, hyperflexion sternal fracture can occur, particularly in a woman with female athlete triad.
该病例提高了对分娩期间胸骨骨折诊断的认识，避免了冗长且耗费高昂的检查。本报告确定了可能患这种疾病风险较高的一部分女性。
在诊断和治疗一名在分娩期间自发性胸骨骨折的患者后，我们回顾了先前报道的病例并强调了该疾病的关键点。
我们报告了第三例患有女性运动员三联征的健康初产妇在分娩期间发生胸骨骨折的病例。分娩12小时后，该女性接受了硬膜外麻醉。到16小时时，宫颈完全扩张。在第二次以 chin-to-chest 姿势用力时，一个健康的婴儿出生，但母亲出现急性前胸痛。压痛持续了三周。X线平片证实了骨折的存在，骨折自行愈合。
虽然分娩期间的胸痛通常由包括肺栓塞、心肌梗死和自发性气胸在内的严重原因引起，但过度屈曲性胸骨骨折也可能发生，尤其是在患有女性运动员三联征的女性中。
