Stafford P A, Biddinger P W, Zumwalt R E
Department of Pathology and Laboratory Medicine, University of Cincinnati, OH 45267.
Am J Obstet Gynecol. 1988 Aug;159(2):485-9. doi: 10.1016/s0002-9378(88)80115-7.
Eight cases of lethal intrauterine fetal trauma secondary to motor vehicle accidents are retrospectively studied. In each instance the mother survived, usually sustaining only minor injuries. Some degree of placental abruption or infarction occurred in each case, but fetal abnormalities were more varied. Significant fetal injuries were limited to the head and included two instances of skull fracture associated with cortical lacerations and contusions. Six of the eight fetuses were stillborn, and the other two died during the first postnatal day. At least five of the mothers were unrestrained at the time of the accident, three of whom experienced abdominal impact against the steering wheel but no external abdominal injuries. Although two mothers were wearing seat belts, in only one instance could the seat belt be implicated in contributing to the fetal injury. This study shows that lethal placental or direct fetal injury can occur even though maternal injuries are minor or insignificant. The findings also support current recommendations for use of three-point restraints.
对8例因机动车事故导致的致命性胎儿宫内损伤病例进行回顾性研究。在每例病例中，母亲均存活，通常仅受轻伤。每例均发生了一定程度的胎盘早剥或梗死，但胎儿异常情况更为多样。严重的胎儿损伤仅限于头部，包括2例伴有皮质裂伤和挫伤的颅骨骨折。8例胎儿中有6例死产，另外2例在出生后第一天死亡。至少5名母亲在事故发生时未系安全带，其中3名母亲腹部撞到方向盘，但腹部无外部损伤。尽管有2名母亲系了安全带，但只有1例安全带可能与胎儿损伤有关。本研究表明，即使母亲损伤轻微或不明显，也可能发生致命的胎盘或直接胎儿损伤。这些发现也支持目前使用三点式安全带的建议。
