Pelvic Fracture
Fractures of the pelvis account only for about 0.3-6% of all fractures. A pelvic fracture can simply be described as a break in one or more bones comprising the pelvis. Pelvic fracture is a serious condition and requires immediate medical intervention.
The worst pelvic fractures are caused by high-speed accidents such as car accidents or motorcycle accidents or falls from high places, which have major impact on the body. The greater the force, the more severe the fracture. Depending upon the direction and degree of the force, these injuries can be life threatening.
Other injuries such as broken bones or damage to liver, kidneys or other organs.
Pelvic fracture also occurs in people with osteoporosis.
Pelvic fracture occurs among teens, involved in sports and athletic activities such as football, hockey, skiing and long distance running. These fractures occur with sudden muscle contractions.
Pelvic fracture is usually caused by falls in elderly people, especially when getting out of a bathtub or descending stairs.
Symptoms of pelvic fracture include severe pain in the groin, hip or lower back area. The pain is bound to worsen when moving the legs. There may be pain in the abdomen and numbness and tingling sensation in the groin or legs. Bleeding from the vagina, urethra or rectum is often noticed with pelvic fractures. There may be difficulty in urinating and difficulty in walking or standing.
Types of Pelvic fractures
Stable or unstable pelvic fractures: In stable pelvic fracture, there is minimal hemorrhage. The break occurs in one point in the pelvic ring. In unstable pelvic fracture, the pelvis becomes unstable. The break occurs in two or more break points in the pelvic ring. There occurs moderate to severe hemorrhage.
Open or closed pelvic fractures: If open skin wound occurs during the fracture in the lower abdomen, it is called open pelvic fracture. If no skin wounds occur, then it is closed pelvic fracture.
Diagnostic tests such as x-rays, CT scans are used to diagnose pelvic fractures. MRI allow a detailed picture of the pelvic area. Abdominal ultrasound is used to find internal bleeding and other injuries within the abdomen. Urethrography may be conducted to check injuries in urethra by means of an injected dye. Arteriography, in which dye is injected in the arteries to check for internal bleeding within the pelvis, is sometimes used.
Treatment to the pelvic fracture depends upon the severity of the injury caused. A pelvic fracture is a serious injury. In some cases, it may be complicated with injuries in other parts of the body and severe shock as well. Sometimes severe internal and external bleeding and damage to the internal organs could occur. In these situations, immediate attempt is made by the emergency doctor to stop internal and external bleeding caused by the injury. In case of minor fracture, the treatment would merely consist of bed rest and painkillers.
Most of the times, surgery is undertaken to repair the pelvic fracture. Healing after surgery can take anywhere between few weeks to several months. Thus a lengthy rehabilitation becomes necessary after an extensive pelvic surgery. Tubal Pregnancy
Tubal pregnancy is also known as ectopic pregnancy - a condition where the fertilized egg implants itself in the fallopian tubes or any other tissue outside of the uterus. Tubal pregnancy can be life threatening, if not attended to in time. This is because it can lead to the rupture of the pelvic organ and consequent hemorrhage. It can also affect the woman's ability to become pregnant later.
Since it is impossible to carry a tubal pregnancy to term, it becomes imperative to resort to surgery to remove the products of conception since they cannot develop into a fetus. This is done without damage to fallopian tubes, as far as possible. This can be done with laparoscopy in non-emergency situations. Tubal pregnancy can happen to any woman but there are some causes that can increase the likelihood of such a pregnancy condition. Some of the causes for tubal pregnancy are: Pelvic Inflammatory Disease, endometriosis or tubal scarring. Infection of the fallopian tubes such as gonorrhea or chlamydia can lead to a tubal pregnancy. The risk of ectopic pregnancy is manifold in cases of pregnancy after tubal sterilization. The use of the 'morning after pill' - emergency contraception is often noticed as a cause for tubal pregnancy.
An ectopic pregnancy is usually detected in the first 5 - 10 weeks of pregnancy. Ultrasound tests and hCG levels in the blood can help in identifying an ectopic pregnancy. The rate of increase of hCG in the blood is much slower in the case of an ectopic pregnancy or a potential miscarriage. Lower progesterone levels can also be an indication of likely tubal pregnancy. A woman having a tubal pregnancy will experience lower abdominal pain with cramping. There may be abnormal vaginal bleeding and breast tenderness. Lower back pain is another symptom. Severe bleeding and hemorrhage is the most dangerous symptom of ectopic pregnancy and needs prompt medical attention. If there is an emergency situation, there may be a need for blood transfusion.
Placenta Previa
Placenta Previa is a condition where the placenta embeds itself in such a way that it partially or completely covers the cervix. In such a case, the placenta lies low in the uterus and is at risk of separation from the uterine wall during labor contractions. When a pregnant woman experiences painles vaginal bleeding during the third trimester, the doctor may conduct an ultrasound to check for placenta previa. Other symptoms that might indicate placenta previa are a large uterine size, breech or transverse position of the baby or premature contractions.
usually placenta previa is detected during routine ultrasound scans of the growing fetus. Women who are over 35 years or have had multiple pregnancies are at higher risk of placenta previa. If a woman is diagnosed with placenta previa, she will need to take bed rest. Often hospitalization is necessary. Travel must be avoided and pelvic examination by the doctor is not advisable. Instead the doctor will resort to ultrasounds and MRI.
Placenta previa can cause growth retardation in the fetus due to irregularly placed placenta. This can lead to increased chances of congenital anomalies. The expectant mother is at risk for hemorrhage. Blood transfusion is resorted to in cases of severe bleeding.
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