Kim Jinjoo, Kim Seokyung, Kwak Dongwook, Choi Donghwan
Division of Trauma Surgery, Department of Surgery, Ajou University School of Medicine, Suwon, Korea.
Department of Obstetrics and Gynecology, Ajou University School of Medicine, Suwon, Korea.
J Trauma Inj. 2025 Mar;38(1):61-65. doi: 10.20408/jti.2024.0050. Epub 2024 Dec 4.
Trauma during pregnancy poses a potentially tragic risk to both the fetus and mother, making its management particularly challenging. Here, we present the case of a 35-year-old woman at 34 weeks and 2 days gestation who was in a motor vehicle accident and subsequently suffered placental abruption and underwent an emergency cesarean section. We also present a review of traumatic placental abruption and its epidemiology. On arrival at the trauma bay, the patient showed no significant abdominal findings other than a seat belt sign. However, 2 hours after admission, the patient developed abdominal pain and vaginal bleeding. Ultrasonography revealed no clear evidence of placental abruption. This case demonstrates the necessity of close maternal and fetal monitoring with cooperation between the trauma and obstetric teams. Even in the absence of typical symptoms such as abdominal pain on initial presentation, a high-energy mechanism of injury should be suspected.
孕期创伤对胎儿和母亲都构成了潜在的巨大风险,这使得对其进行处理极具挑战性。在此,我们报告一例妊娠34周零2天的35岁女性病例,该患者遭遇机动车事故,随后发生胎盘早剥并接受了紧急剖宫产。我们还对创伤性胎盘早剥及其流行病学进行了综述。患者到达创伤急救区时,除安全带压痕外,腹部未发现明显异常。然而,入院2小时后,患者出现腹痛和阴道出血。超声检查未发现胎盘早剥的确切证据。该病例表明,创伤团队和产科团队合作对母婴进行密切监测非常必要。即使最初就诊时没有腹痛等典型症状,也应怀疑存在高能量损伤机制。