Blows to the maternal abdomen causing fetal demise: report of three cases and a review of the literature.

Traumatic abruption results in 6% of third-trimester gravidas who are hit or kicked in the abdomen during assaults. Three cases are presented in which blows inflicted to the abdomen of pregnant women in their third trimester resulted in the death of the fetus due to abruptio placentae. Two cases were domestic altercations while one was a third-party criminal assault. In all cases the gravida herself escaped significant intra-abdominal injury, and external abdominal findings were minimal. The clinical signs were a history of loss of fetal movements shortly after the assault and loss of fetal heart tones within hours after the assault. One patient had vaginal bleeding; one had uterine contractions. In the cases of domestic abuse, both women initially gave false histories of how the injury occurred.