A gravida 2, para 0-0-1-0 woman with an uneventful antenatal course is a restrained driver in a head-on, high-speed motor vehicle accident at a reported gestational age of 27 weeks and 4 days. Her airbag did not deploy because it was not operational. Her presentation is significant for tachycardia, normal blood pressure, and abdominal and hip pain. Bedside ultrasonography confirms fetal heart tones, breech position, and normal amniotic fluid index. Maternal physical examination demonstrates nasal trauma, bruising in the distribution of a seatbelt, and vaginal bleeding. Trauma computed tomography (CT) of the chest, abdomen, and pelvis shows no maternal injuries. Electronic fetal monitoring is significant for a category III tracing: baseline fetal heart rate (FHR) in the 180s, with minimal variability and recurrent late decelerations and contractions every 3 minutes. The decision for emergent cesarean delivery is made in the setting of nonreassuring fetal status with concern for placental abruption....
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Index of Suspicion in the Nursery|
May 01 2020
Case 1: Neonatal Trauma Following Motor Vehicle Collision in Pregnancy
Laura N. Shashy, MD;
Laura N. Shashy, MD
*Division of Neonatology, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
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Amanda M. Craig, MD;
Amanda M. Craig, MD
†Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN
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Lauren A. Sanlorenzo, MD, MPH;
Lauren A. Sanlorenzo, MD, MPH
*Division of Neonatology, Department of Pediatrics, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Nashville, TN
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Sarah S. Osmundson, MD, MS
Sarah S. Osmundson, MD, MS
‡Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Vanderbilt University Medical Center, Nashville, TN
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AUTHOR DISCLOSURE
Drs Shashy, Craig, Sanlorenzo, and Osmundson have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
Neoreviews (2020) 21 (5): e342–e344.
Citation
Laura N. Shashy, Amanda M. Craig, Lauren A. Sanlorenzo, Sarah S. Osmundson; Case 1: Neonatal Trauma Following Motor Vehicle Collision in Pregnancy. Neoreviews May 2020; 21 (5): e342–e344. https://doi.org/10.1542/neo.21-5-e342
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