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Published on: October 25, 2015
[Intra-uterine fetal death by knife: case report]
1Services des urgences chirurgicales viscérales, CHU d'Ibn-Rochd, Casablanca, Maroc.
Introduction:
Opened injuries by knife are rare in pregnant women and are responsible of foetal death in most cases.
Observation And Commentary:
We report a case of a 27-years woman, in her 8th months of pregnancy, victim of three knife punchs in her right iliac fossa. An emmergent laparotomy revealed deep wounds in the uterus and its right vascular pedicles, and a right external iliac artery lesion. Hysterectomy was performed and the extracted fetus was dead. He had two wounds in skull and back. Foetal death is common in opened knife injuries especially at the end of pregnancy. On one hand, the fetus has an abdominal situation that expose him to penetrating lesions. On the other hand, the uterus is richly vascularized during this period of pregnancy, thus any uterine or pedicular wound could result in a maternal hemorrhagic shock and hence a poor foetal and maternal prognosis.
Conclusion:
Knife injuries in pregnant women could compromise the foetal prognosis. Managmanent should be early and requires a close collaboration between resuscitators, obstetricians and vascular surgeons.
