title: Obstetric and gynecological outcome in a patient with traumatic pelvic fracture and perineal injuries.
abstract: A 19-year-old woman presented with pelvic trauma following a road accident. She was hemodynamically stable. Examination revealed perineal injuries and type C pelvic fracture, which was stabilized with an external fixator. The broken ends of the pubic bone were brought together by an orthopedic wire. The detached vaginal wall and torn anal sphincter were surgically repaired after making a diverting colostomy. The postoperative period was uneventful. Colostomy was reversed after 3 months. Postoperatively the patient developed a cystocele, dyspareunia and vaginal pain. She conceived spontaneously and was planned for an elective cesarean at 37 weeks gestation; however, she presented in labor at 36 weeks and had a normal vaginal delivery. Pelvic fractures may be associated with genitourinary and anal sphincter injuries, which require management by a multidisciplinary team. On recovery the patient may develop prolapse, dyspareunia and persistent local pain. Spontaneous conception and normal vaginal delivery are nevertheless possible.
authors.affiliation: Department of Obstetrics and Gynecology Orthopedics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. drdeeptigoswami@hotmail.com
authors.forename: Deepti
authors.initials: D
authors.lastname: Goswami
authors.forename: Puneet Kaur
authors.initials: PK
authors.lastname: Kochhar
authors.forename: Tarun
authors.initials: T
authors.lastname: Suri
authors.forename: Vijay
authors.initials: V
authors.lastname: Zutshi
authors.forename: Swaraj
authors.initials: S
authors.lastname: Batra
mesh_terms: D001003:Anal Canal / Q000293:injuries*; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010502:Perineum / Q000293:injuries*; D011247:Pregnancy; D011630:Pubic Bone / Q000293:injuries*; D014621:Vagina / Q000293:injuries*; D014950:Wounds, Penetrating / Q000150:complications; D055815:Young Adult