Sacral and pubic ramus fractures - 12 weeks pregnant

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Pedestrian hit by car. 12 weeks pregnant. IVDU.

Patient Data

Age: 30 years
Gender: Female

Undisplaced fracture of the right sacral ala involving the right anterior S1 and S2 neural foramina. No widening of the SI joints.

Minimally displaced fracture of the right inferior pubic rami.

Soft tissue contusion overlying the left iliac crest.

No acute intra-abdominal pathology detected. Gravid uterus.

Case Discussion

Bedside FAST was negative and pelvic US showed a single irregular gestational sac without a definite fetal pole. Some PV loss was reported at the roadside after the trauma. Formal US after the trauma CT confirmed loss of pregnancy.

Traumatic pelvic fractures in pregnant women have a very high fetal mortality rate.  

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