Seat belts: a potential hazard to the fetus

The widespread introduction of seat belts for front seat passengers has undoubtedly reduced injury and death during impact but the effects on the fetus of belt restraint has been little reported. We report here a fetus whose mother was involved in a low speed head-on collision and who rapidly developed abdominal tenderness. The fetus was bradycardic and emergency cesarean section delivered an infant who was shocked due to placental abruption and who required immediate resuscitation. The baby subsequently developed renal failure and convulsions but on follow-up is entirely normal. We draw attention to the fact that maternal seat belt trauma may cause placental abruption with severe fetal compromise. Careful assessment of fetal cardiotocography should be performed in all pregnancies where a deceleration collision in the presence of a maternal seat belt restraint makes fetal injury a possibility.