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

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.