Seat belt placement resulting in uterine rupture

A 20-year-old woman with a 27-week intrauterine pregnancy was admitted to a Level II trauma center after a motor vehicle crash. She had a seat belt abrasion over her lower abdomen. Fetal death was established, and subsequent computed tomographic scanning detected uterine rupture with intra-abdominal displacement of the fetus. This finding dispelled any thought of placental abruption and led directly to laparotomy with repair of the uterus and removal of the dead fetus. Recently, and 7 years after the trauma, the patient presented for prenatal care of a new pregnancy. Proper seat belt placement is reviewed and the value of abdominal computed tomographic examination is underscored. An updating comment about airbags is included.