European Journal of Biomedical and Pharmaceutical Sciences

UTERUS TORSION@ 270 DEGREES RARE CASE REPORT

Neethika Raghuwanshi*

ABSTRACT

Torsion of the pregnant uterus, at term, is a very rare event in obstetric practice. It is associated with high perinatal mortality but in our case report the torsion remained asymptomatic till patient landed in labour pains. We are reporting a case of uterine torsion, where a booked second gravida with previous lower segment cesarean section underwent an emergency cesarean section due to severe lower abdominal pain, with uterine contractions poor Bishop Score and transverse lie. Diagnosis made on laprotomy tried to untwist the uterus but could not attempt more than 90 degrees which gave avascular posterior surface. Following delivery uterus untwisted on itself through180 degrees. To the surprise right adnexa was absent. Patient had history of laproscopy . The non- specific clinical course and rarity of this condition makes the preoperative diagnosis difficult and raises critical management considerations. This article reviews the pathophysiology, clinical presentation, diagnosis and management of uterine torsion in pregnancy. There is no study of outcome and management of pregnancies with both anterior and posterior uterine scars. Efforts need to be made to develop consensus for management of these cases, in future.

Keywords: Uterine torsion. Cesarean section. Pregnancy. Right salphingoopherectomy.