Document Detail


The role of placental pathology in the evaluation of interpersonal violence: a case of abdominal gunshot wound in a 27-week gravid uterus.
MedLine Citation:
PMID:  12478455     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present a 17-year-old G1P0 Asian American woman with a previously undiagnosed pregnancy who sustained an intra-abdominal gunshot wound at 27 weeks' gestation. Within 2 hours of the traumatic event, the victim was taken emergently to the operating room for exploratory laparotomy. Findings included a gravid uterus with two entrance wounds and two small exit wounds with active bleeding from the right broad ligament. The fetus was bradycardic but viable, having suffered a gunshot wound to the left shoulder. Evaluation of the placenta revealed no sequelae from the acute event. Unexpectedly, two older, green, 7.0 cm retromembranous hematomas were present, both ringed by hemosiderin-laden macrophages. These hemorrhages clearly preceded the acute event. Although these findings seemed suspicious for a history of prior abuse or trauma, corroborative clinical data were unavailable at the time of initial placental evaluation. However, days later, the victim admitted to a history of interpersonal violence, with previous abuse from her boyfriend, a fatal victim of the same attack. The old retroplacental hemorrhages proved to be the only physical documentation of her previous abuse.
Authors:
Kerith Overstreet; Frank L Mannino; Kurt Benirschke
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of perinatology : official journal of the California Perinatal Association     Volume:  22     ISSN:  0743-8346     ISO Abbreviation:  J Perinatol     Publication Date:  2002 Dec 
Date Detail:
Created Date:  2002-12-12     Completed Date:  2003-04-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8501884     Medline TA:  J Perinatol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  675-8     Citation Subset:  IM    
Affiliation:
Department of Pathology, UCSD Medical Center, San Diego, CA 92103, USA.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / pathology*
Abdominal Injuries / etiology,  pathology*,  therapy
Adolescent
Domestic Violence*
Female
Gestational Age
Gravidity
Humans
Infant, Newborn
Male
Placenta / injuries*,  pathology*
Pregnancy
Time Factors
Uterus / injuries*,  pathology*
Wounds, Gunshot / complications,  pathology*,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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