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Case Report
 
Torsion of preterm gravid uterus: A case report
Sabuhi Qureshi1, Uma Singh2, Bhumika Bansal3, Nisha Singh4
1MS, (OBGYN), D.N.B (OBGYN), Associate Professor, Dept of OBGYN, CSM Medical University, Lucknow, UP, India.
2MS, (OBGYN), Professor and Unit head, Dept of OBGYN, CSM Medical University, Lucknow, UP, India.
3MBBS, Junior resident, Dept of OBGYN, CSM Medical University, Lucknow, UP, India.
4MD, (OBGYN), Professor, Dept of OBGYN, CSM Medical University, Lucknow, UP, India.

doi:10.5348/ijcri-2013-07-339-13

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How to cite this article:
Qureshi S, Singh U, Bansal B, Singh N. Torsion of preterm gravid uterus: A case report. International Journal of Case Reports and Images 2013;4(7):392–395.


Abstract
Introduction: Rotation of the gravid uterus is a normal occurrence in the third trimester of pregnancy. However, a pathologic rotation of the uterus beyond 45 degrees i.e, torsion of the entire uterus-is rarely encountered. We report here a case of uterine torsion from our obstetrical practice.
Case Report: A young 25-year-old second gravida, para one presented with features of antepartum hemorrhage (Abruptio placentae) with intrauterine fetal demise at 25 weeks of pregnancy. During laparotomy uterine torsion of 180 degrees was diagnosed. As all attempts at detorsion failed, a deliberate posterior lower segment incision was made to deliver the baby. Subtotal hysterectomy had to be done as conservative procedures (utertonics, uterine artery ligation, B-Lynch suture) to control postpartum hemorrhage failed. The patient was recovering in the postoperative period, when she died unfortunately of a suspected pulmonary embolism.
Conclusion: Uterine torsion is an infrequently reported and potentially dangerous complication of pregnancy that occurs mainly in the third trimester with adverse maternal and neonatal consequences. Aetiopathogenesis of this condition is still unclear. The diagnosis is usually made at laparotomy. Often posterior lower segment incision is used for delivering the baby. It merits consideration as a differential diagnosis of acute abdomen in pregnancy.

Keywords: Torsion uterus, Gravid uterus, Preterm gestation


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Author Contributions
Sabuhi Qureshi – Conception and design, Acquisition of data, Analysis and interpretation of data, Critical revision of the article, Final approval of the version to be published
Uma Singh – Conception and design, Critical revision of the article, Final approval of the version to be published
Bhumika Bansal – Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Nisha Singh – Conception and design, Critical revision of the article, Final approval of the version to be published
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The corresponding author is the guarantor of submission.
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Conflict of interest
Authors declare no conflict of interest.
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© Sabuhi Qureshi et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.)