Spontaneous sternal fracture during labor in a healthy primigravida with female athlete triad: A case report

Case Rep Womens Health. 2020 May 5:27:e00213. doi: 10.1016/j.crwh.2020.e00213. eCollection 2020 Jul.

Abstract

Introduction: This case raises awareness of the diagnosis of sternal fracture during labor and obviates the need for lengthy, expense-consuming workup. This report identifies a subset of women who may be at higher risk for this pathology.

Methods: Upon diagnosing and treating a patient who spontaneously fractured her sternum during labor, we reviewed previously reported cases and highlight key points of this entity.

Results: We report the third case of sternal fracture during labor in a healthy primigravida with female athlete triad. After 12 h of labor, the woman underwent epidural placement. By 16 h, the cervix was fully dilated. During the second push in the chin-to-chest position, a healthy baby was delivered, but the mother experienced acute anterior chest pain. Tenderness persisted for three weeks. Plain radiographs confirmed the presence of the fracture, which healed spontaneously.

Conclusion: While chest pain during labor often results from serious causes including pulmonary embolism, myocardial infarction, and spontaneous pneumothorax, hyperflexion sternal fracture can occur, particularly in a woman with female athlete triad.

Keywords: Female athlete triad; Labor; Sternal fracture.

Publication types

  • Case Reports