17.3.5 Trauma to the abdomen
Any blunt or penetrating trauma to the abdominal wall can result in a break in the fetal membranes. Blunt traumas include: uterine manipulation by a doctor or midwife to change the fetal presentation from breech or transverse lie to the normal ‘head down’ or vertex presentation; uterine massage by traditional healers; and blunt abdominal injury (e.g. from a blow or fall). An example of a penetrating abdominal injury is insertion of a hollow needle into the amniotic cavity through the abdominal wall, or through the cervix, to withdraw amniotic fluid or placental tissue for analysis.