Case ReportPulmonary Embolization by Chorionic Villi Causing Maternal Death After a Car CrashKingston, Nicola J. MB, ChB; Baillie, Tina MB, ChB, FRCPA; Chan, Yuen F. MB, BS, FRCPA, MRCPath; Reddy, Desmond J. MB, ChB, FRCPA; Stables, Simon R. MB, ChB, FRCPAAuthor Information From the Department of Anatomical Pathology, Auckland Hospital, Auckland, New Zealand, (N.J.K., T.B.), the Department of Anatomical Pathology, Carlton, Melbourne, Australia (Y.F.C.), the Northland Path Lab, Whangarei, New Zealand (D.J.R.) and the Department of Forensic Pathology, Auckland Hospital, Auckland, New Zealand (S.R.S.). Manuscript received January 16, 2003; accepted March 7, 2003. Address correspondence and reprint requests to Tina Baillie, Consultant Histopathologist, Histopathology Laboratory, LabPlus, Level 2, Building 31, Auckland Hospital; E-mail: [email protected] The American Journal of Forensic Medicine and Pathology: June 2003 - Volume 24 - Issue 2 - p 193-197 doi: 10.1097/01.PAF.0679069504.53671.05 Buy Metrics Abstract Throughout the last century, there has been a marked decline in obstetric maternal deaths, resulting in an increase in the proportion of nonobstetric deaths among pregnant women. Trauma, in particular, has become a leading cause of maternal death. We report the case of a 20-year-old primigravid woman who was involved in a motor vehicle crash at 36 weeks gestation. The woman developed abruptio placentae, followed by disseminated intravascular coagulation, adult respiratory distress syndrome, and shock, and died the day after the crash. Widespread pulmonary embolization by chorionic villi was identified at autopsy. This report discusses traumatic maternal deaths, with emphasis on the differences in injury pattern observed in pregnant trauma victims in comparison with other adults. It is important that the pathologist be aware of these problems so that an accurate cause of death can be identified in cases of maternal death after trauma. Also discussed is the relationship between trauma and placental abruption and the mechanism of death in the patient. To the authors’ knowledge, this is the first reported case of extensive embolism of chorionic villi to the lungs after trauma. © 2003 Lippincott Williams & Wilkins, Inc.