Fetal strangulation following uterine rupture.

A woman who was 30 weeks pregnant was sitting with a three-point seat belt fastened in the front passenger seat of an automobile that was involved in a head-on collision. On admission to hospital, the fetus was found in a breech position with the fetal head situated just beneath the mother's liver. Laparotomy had to be performed 4 h later and the fetus was found to have been completely expelled from the uterine cavity through a rupture in the fundus uteri. The findings in the fetus suggest that the head was expelled first, and that the fetus was then strangled by uterine contractions. The significance of using seat belts during pregnancy is discussed briefly.