CONSERVATIVE OBSTETRIC MANAGEMENT OF A GUNSHOT WOUND TO THE 2ND-TRIMESTER GRAVID UTERUS - A CASE-REPORT

BACKGROUND: Gunshot wounds to the abdomen during pregnancy are becomin g increasingly common. When the gravid uterus is injured but repairabl e and the fetus is either previable or dead, conservative manage ment is an option, even if laparotomy is required for management of other i njuries. CASE: A pregnant woman sustained a gunshot wound to the abdom en during the second trimester of pregnancy. The bullet injured the re ctum and traversed the uterine cavity, with resultant rupture of membr anes and direct,fatal injury to the fetus. Laparotomy was required for treatment of the maternal injuries; however, the pregnancy was manage d conservatively. Spontaneous miscarriage occurred late on the second postoperative day. CONCLUSION: Conservative obstetric management is in dicated in most such cases in which the fetus is previable or dead, al though the clinician undertaking such management should be aware of th e risks and possible complications.