Crush injury of the urethra and vulva, an unusual cause of antepartum haemorrhage – a case report: challenges in management

Abstract

Objective: To highlight this uncommon cause of antepartum haemorrhage, the multi specialist involvement and strategies to overcome the challenges posed by management. Methodology: Documentation of patient’s management from presentation to discharge, highlighting the peculiar challenges encountered in the process. Result: We present a 30-year-old G4P2+1lady who had crush injury of the vulva and urethra following a road traffic accident involving her motorcycle at 32 weeks’ gestation. She was resuscitated from shock with intravenous fluids and blood transfusion and had supra-pubic cystostomy due to urinary retention. Two weeks after caesarean delivery of a 2.4kg male baby at 36 weeks of gestation, she had reconstruction of the urethra with rail-roading following a micturatingcystourethrography. Patient and baby were discharged home from hospital a week after the reconstruction after spending a total of seven weeks on admission. Conclusion: Crush injury of the urethra and vulva in pregnancy could result in death or near miss experience if not adequately handled. It may as in the case managed require the involvement of other specialists for a satisfactory outcome.