Uterine rupture following motor vehicle collision: possible seatbelt induced lesions

Road traffic accidents rank among the leading non-obstetric causes of maternal and fetal death. We present a case of a motor vehicle collision involving a pregnant woman at term. In the initial evaluation, the patient was haemodynamically unstable and had an extensive abdominal haematoma. Abdominal ultrasound revealed fetal death and a significant quantity of intra-abdominal free fluid. An emergent exploratory laparotomy was performed, confirming a transverse uterine rupture, significant haemoperitoneum, and a dead fetus in the peritoneal cavity. Additional injuries included right infundibulopelvic ligament haematoma, rectus abdominis muscle section, dorsal vertebral body fracture and rib and ileopubic branch fractures. Uterine repair and right adnexectomy were performed. Despite fetal death, the patient survived, and the uterus and left adnexa were preserved.