Sherer D M, Abramowicz J S, Babkowski R, Metlay L A, Ron M, Woods J R
Department of Obstetrics and Gynecology, Strong Memorial Hospital, University of Rochester School of Medicine and Dentistry, New York 14642-8668.
Am J Perinatol. 1993 Nov;10(6):414-6. doi: 10.1055/s-2007-994619.
Motor vehicle accidents are the primary nonobstetric cause of maternal and subsequent fetal mortality. We present a case in which blunt abdominal trauma sustained by a pregnant woman in a motor vehicle accident caused extensive intrathoracic fetal injuries consisting of bilateral hemothorax, severe bilateral interstitial pulmonary hemorrhages, hemopericardium, and subepicardial hemorrhages, in addition to fetal cranial injuries. To the best of our knowledge, this is the first report of fetal intrathoracic injuries sustained with blunt maternal trauma. The underlying mechanism of intrathoracic trauma was thought to be similar to that of blast injury with transmission of excessive hydrostatic forces throughout the amniotic fluid with severe impact on the elastic fetal chest. This case supports the concept of in utero blast injury to the fetus as a possible cause for fetal soft tissue trauma associated with blunt trauma to the maternal abdomen.
机动车事故是孕产妇及随后胎儿死亡的主要非产科原因。我们报告一例病例，一名孕妇在机动车事故中遭受钝性腹部创伤，导致胎儿广泛的胸腔内损伤，包括双侧血胸、严重的双侧间质性肺出血、心包积血和心外膜下出血，此外还有胎儿颅脑损伤。据我们所知，这是第一例关于母亲钝性创伤导致胎儿胸腔内损伤的报告。胸腔内创伤的潜在机制被认为类似于爆炸伤，即过度的静水压力通过羊水传递，对弹性胎儿胸部造成严重影响。该病例支持胎儿宫内爆炸伤这一概念，认为它可能是与母亲腹部钝性创伤相关的胎儿软组织创伤的一个原因。
