title: Extensive fetal intrathoracic injuries sustained in a motor vehicle accident.
abstract: 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.
authors.affiliation: Department of Obstetrics and Gynecology, Strong Memorial Hospital, University of Rochester School of Medicine and Dentistry, New York 14642-8668.
authors.forename: D M
authors.initials: DM
authors.lastname: Sherer
authors.forename: J S
authors.initials: JS
authors.lastname: Abramowicz
authors.forename: R
authors.initials: R
authors.lastname: Babkowski
authors.forename: L A
authors.initials: LA
authors.lastname: Metlay
authors.forename: M
authors.initials: M
authors.lastname: Ron
authors.forename: J R
authors.initials: JR
authors.lastname: Woods
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D006259:Craniocerebral Trauma / Q000209:etiology; D005260:Female; D005313:Fetal Death / Q000209:etiology*; D005315:Fetal Diseases / Q000209:etiology*; D006331:Heart Diseases / Q000209:etiology; D006335:Heart Injuries / Q000209:etiology*; D006470:Hemorrhage / Q000209:etiology; D006491:Hemothorax / Q000209:etiology; D006801:Humans; D008171:Lung Diseases / Q000209:etiology; D055370:Lung Injury; D008297:Male; D010490:Pericardial Effusion / Q000209:etiology; D011247:Pregnancy