Gunshot wound of the fetus

Abstract

We report here a fetus, who was delivered via cesarean section in 32th gestational week from a 37-year-old mother and sustained multiple gunshots. Post-natal evaluation revealed eight entry-exit holes and the baby was transferred to our clinic.Upon admission, peripheral pulses were nonpalpable, appropriate fluid administration and blood transfusion were conducted and further examinations revealed bladder perforation. Bladder was repaired over a suprapubic catheter and bullet holes were primarily sutured. Left foot drop was observed on follow up and the patient was discharged with no further complication. Although the maternal and the fetal morbidity and mortality rates are high in intrauterine gunshot wounds, appropriate management may provide survival as seen in our case.

Maternal and Neonatal Outcomes of Gunshot Wounds in Pregnancy: A Systematic Review of Case Reports

“…56 Table 1 demonstrates the results of the appraisal, finding all 41 studies to be detailed enough to be replicated, relevant to contemporary practice, and demonstrate adequately ascertained exposure (GSW) and coprimary outcomes (maternal and/or neonatal death). While 82% (34/41) of studies had adequate follow-up of surviving patient(s) until or beyond discharge, [4][5][6][7][8][12][13][14][15][16][17][18][19][20][23][24][25][27][28][29][30][31][32][33][34][35][36][38][39][40][41][42][43][44] few studies (6/41) with a clear selection method were limited to the case series and small registries in this review. 5,6,11,16,41,43 In the GRADE 57 assessment of our review based on observational studies, our certainty of evidence was downgraded due to risk of selection bias and upgraded as possible confounders not discussed in the studies (comorbidities, obstetric history, socioeconomic status, degree of education, global variation in standards of care, etc.)…”

“…56 Table 1 demonstrates the results of the appraisal, finding all 41 studies to be detailed enough to be replicated, relevant to contemporary practice, and demonstrate adequately ascertained exposure (GSW) and coprimary outcomes (maternal and/or neonatal death). While 82% (34/41) of studies had adequate follow-up of surviving patient(s) until or beyond discharge, 4-8,12-20,23-25,27-36,38-44 few studies (6/41) with a clear selection method were limited to the case series and small registries in this review. 5,6,11,16,41,43…”

“…2,3 The primary literature on maternal and neonatal outcomes of GSW in pregnancy is limited, with most publications consisting of case reports or small case series. 4-44 Several reports 45-49 predate the classification of perimortem cesarean delivery as the primary method of maternal resuscitation. 50…”

Prenatal gunshot wound, a rare cause of maternal and fetus trauma, a case report

“…Fetal loss after trauma often develops from prolonged maternal hypotension, placental abruption, uterine rupture, direct trauma to the uterus, or maternal death [6]. Penetrating trauma cases during pregnancy are rare, and account only for 1.5% of episodes of trauma during pregnancy.…”

Residual pellet in fetal brain tissue following a gunshot injury to a pregnant woman: a case report

“…Gun ve arkadaşları, [6] bir olguda saçma tanelerinin fetüsün idrar kesesine penetre olduğu, 32 haftalık gebeliğin sonlandırılarak mesane onarımı yapıldığı ve bebeğin normal yaşamını sürdürebildiğini bildirilmiş-lerdir. Diğer bir ateşli silah yaralanması olgusunda da uterusun rüptüre olmasına rağmen fetüste yüzeyel cilt sıyrıkları saptandığı, hem anne hem de bebeğin yaşa-tılabildiği belirtilmiştir.…”