Complete fetal transection after a motor vehicle collision.

Abstract

Motor vehicle collisions are the leading cause of fetal death related to maternal trauma, with rupture of the gravid uterus being one potential grave outcome. We present a case of a woman at 22 weeks of gestation who presented to the emergency department after a "high-speed" motor vehicle collision. On initial presentation, she was hemodynamically stable, and the examination was significant for midabdominal transverse ecchymosis from seatbelt trauma. A computed tomography scan identified a probable uterine rupture. Laparotomy revealed a 1,500-mL hemoperitoneum and a completely ruptured uterus requiring hysterectomy. The fetus was completely transected at the level of the midabdomen. Uterine rupture is possible for gravid women involved in motor vehicle collisions.