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May 30, 1977

Thoracoabdominal Gunshot Wound With Survival of a 36-Week Fetus

JAMA. 1977;237(22):2409-2410. doi:10.1001/jama.1977.03270490049027

GUNSHOT wounds to the uterus of a woman during the last months of pregnancy are rare. The lives of the mother and the unborn child are endangered. In a review of 70 such cases, no fetus survived thoracoabdominal gunshot trauma.1 Recently, we treated an infant who suffered a major prenatal gunshot wound. Earlier reviews of uterine trauma focused on treatment of the mother.1 This report concerns treatment of the infant.

Report of a Case  A 23-year-old woman, gravida 5, para 4, approximately 36 weeks gravid, was shot in the midportion of the abdomen with a.38-caliber low-velocity bullet. She was taken to a nearby community hospital, where roentgenograms of the abdomen showed a bullet within the uterus, evidently lodged in an upper extremity of the fetus (Fig 1). Fetal heart tones were present. Immediate celiotomy disclosed no maternal injuries other than to the uterus. A cesarean section was performed,