Intrauterine stab injury of youth pregnant

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Abstract


A distinct tendency to an increased number of pregnancies and deliveries among young women has been observed lately. Pregnant teenagers with various types of traumas can be admitted to a non-profile pediatric surgical in-patient facility where no gynecologist is available. Purpose. The article describes a clinical case of an injury to the uterus and 33–34-week fetus in 17-year-old pregnant woman after an accidental fall on a kitchen knife. Materials and methods. The patient in a severe condition was admitted to the hospital with a knife in the anterior abdominal wall. Post-hemorrhagic anemia was diagnosed (Hb 95 g/L, RBC3.0 х1012/L). Based on urgent indications of an operating team consisting of a pediatric surgeon and an obstetrician-gynecologist, a midline laparotomy was performed. 2L of blood was removed from the cavity, the cutting edge of a knife was removed from the uterus body. No other damages were found during abdominoscopy. Cesarean section was done in the inferior segment of the uterus, an alive fetus was removed, bilateral ligation of uterine arteries was done and a hemostatic supraplacental suture was applied. A double balloon obstetric catheter was used. The uterine wound was sutured. Total blood loss was about 3 L. It was compensated with red blood cells (1385 ml) and fresh frozen plasma (2740 ml) transfusion. The removed boy had a weight of 2,300 g and 2 Apgar scores. Resuscitation activities were successful. The child was taken to the ICU and put on life support. 2 cm long injury was found in the right axillary region not penetrating into the chest. Its primary surgical debridement was done. Postoperative period in a child and mother who was taken to the maternity home went on without complications. The child was examined in a year. He developed according to the age. Conclusions. It can be possible that pediatric surgical departments are not ready for Cesarean section and elimination of possible complications when dealing with pregnant teenagers with various types of traumatic injuries requiring urgent obstetric intervention. That’s why it’s better when the patients are admitted to maternity homes where a pediatric surgeon is available.

About the authors

A. V. Pisklakov

Omsk State Medical University; Regional Children’s Clinical Hospital

Author for correspondence.
Email: pisklakovomsk@mail.ru

Russian Federation

Andrei V. PISKLAKOV - Dr. Sci. (Med.), Professor, Head of the Department of Pediatric Surgery, Omsk State Medical University; Head of the Center for Pathology of Reproductive Organs and Pelvic Surgery

Lenin st., 12, Omsk, 644099
phone: +7 (3812) 36–16–72, +7 (913)631–13–23

S. V. Barinov

Omsk State Medical University

Email: fake@neicon.ru

Russian Federation

Sergey V. BARINOV - Dr. Sci. (Med.), Professor, Head of the Department of Obstetrics and Gynecology No. 2

Lenin str., 12, Omsk, 644099

N. I. Pavlenko

Omsk State Medical University; Regional Children’s Clinical Hospital

Email: fake@neicon.ru

Russian Federation

Natalya I. PAVLENKO - Cand. Sci. (Med.), Assistant of Department of Pediatric Surgery, Omsk State Medical University; Gynecologist of the Center for Pathology of Reproductive Organs and Pelvic Surgery

Lenin str., 12, Omsk, 644099

V. I. Ponomarev

Omsk State Medical University

Email: fake@neicon.ru

Russian Federation

Vyacheslav I. PONOMAREV - Dr. Sci (Med.), Professor of the Department of Pediatric Surgery

Lenin str., 12, Omsk, 644099

A. V. Lysov

Omsk State Medical University

Email: fake@neicon.ru

Russian Federation

Anatoly V. LYSOV - Dr. Sci. (Med.), Professor of the Department of Pediatric Surgery

Lenin str., 12, Omsk, 644099

References

  1. Каримов З. Д., Жабборов У. У., Абдикулов Б. С., Хусанходжаева М. Т. Травмы у беременных: современные аспекты проблемы (обзор литературы). Журнал имени Н. В. Склифосовского «Неотложная медицинская помощь». 2013; 1:33–37
  2. Safdari M., Safdari Z., Pishjoo M. Intrauterine Fetal Traumatic Brain Injury Following Motor Vehicle Accident; A Case Report and Review of the Literature. Bull. Emerg. Trauma 2018;6(4):372–5. https://doi.org/10.29252/beat-060417
  3. Saatian M., Ahmadpoor J., Mohammadi Y., Mazloumi E. Epidemiology and Pattern of Traumatic Brain Injury in a Developing Country Regional Trauma Center. Bull. Emerg. Trauma. 2018;6(1):45–53. https://doi.org/10.29252/beat-060107
  4. Dorairaj J., Sagili H., Rani R., Nanjundan P., Rajendran J., Ananthakrishnan R. Delayed presentation of intraperitoneal bladder rupture following domestic violence in pregnancy. J. Obstet. Gynaecol. 2012;38(4):753–6. doi: 10.1111/j.14470756.2011.01781
  5. Pearce C., Martin S. R. Trauma and Considerations Unique to Pregnancy. Obstet. Gynecol. Clin. North. Am. 2016 Dec; 43(4):791–808. doi: 10.1016/j.ogc.2016.07.008
  6. Brown H. L. Trauma in pregnancy. Obstet. Gynecol. 2009;114(1):147–60. https://doi.org/10.1097/AOG.0b013e3181ab6014
  7. Jain V., Chari R., Maslovitz S., Farine D. Maternal Fetal Medicine Committee, Bujold E., Gagnon R., Basso M., Bos H., Brown R., Cooper S., Gouin K., McLeod N.L., Menticoglou S., Mundle W., Pylypjuk C., Roggensack A., Sanderson F. Guidelines for the Management of a Pregnant Trauma Patient. J. Obstet. Gynaecol. Can. 2015 Jun; 37(6):553–74. https://doi.org/10.1016/S1701–2163(15)30232–2
  8. Huls C. K., Detlefs C. Trauma in pregnancy. Semin. Perinatol. 2018 Feb;42 (1):13–20. doi: 10.1053/j.semperi.2017.11.004.
  9. Rossignol M Trauma and pregnancy: What anesthesiologist should know. Anaesth Crit Care Pain Med. 2016 Oct;35 Suppl 1:S27-S34. doi: 10.1016/j.accpm.2016.06.006. Epub 2016 Jul.
  10. Leroy-Malherbe V., Bonnier C., Papiernik E., Groos E., Landrieu P. The association between developmental handicaps and traumatic brain injury during pregnancy: an issue that deserves more systematic evaluation. Brain. Inj. 2006;20(13–14):1355–65. PMID: 17378227
  11. World Health Organisation. Fact sheets. Adolescent pregnancy. URL: https://https://www.who.int/news-room/fact-sheets/detail/adolescent-pregnancy (дата обращения: 25.06.2019)

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