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Crush injury in pregnancy: an unusual experience in obstetrics
A Schoenfeld1, S Warchaizer, M Royburt
1Department of Obstetrics and Gynecology, Beilinson Medical Center, Petah Tiqva, Israel.
Background:
Crush injury is the result of prolonged pressure to the limbs when individuals are trapped under the debris of earthquakes, bombings, and other disasters. Muscle integrity is compromised, and the local and systemic manifestations, including rhabdomyolysis, hyperkalemia, renal failure, and disseminated intravascular coagulation may be fatal.
Case:
A 32-year-old woman, gravida 2, para 1, was trapped under fallen masonry at 6 weeks' gestation for approximately 6 hours. On initial examination, she showed early signs of hypovolemic shock and crush injury, including hyperkalemia. Prompt management with fluid therapy and careful monitoring led to a rapid recovery. Antenatal follow-up was routine and concluded in spontaneous delivery of a healthy infant.
Conclusion:
The unique physiology of the pregnant woman may affect the outcome of crush injury, and it presents a particular challenge to the trauma team. The obstetrician should be aware of its dangers and should be an active participant in the prompt management of pregnant victims of crush injury to ensure a satisfactory outcome for both mother and fetus.
