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Medline ® Abstract for Reference 25

of 'Approach to acute abdominal pain in pregnant and postpartum women'

Uterine torsion in second trimester of pregnancy followed by a successful-term pregnancy.
Fatih FF, Gowri V, Rao K
BMJ Case Rep. 2012;2012 Epub 2012 Aug 21.
Uterine torsion is defined as rotation of the uterus of more than 45°on its long axis. It is an unusual complication of pregnancy and for most obstetricians it probably represents a 'once-in-a-lifetime' diagnosis. Fetal mortality up to 12% and occasional maternal mortality are reported. A 22-year-old second gravida presented at 22+ weeks gestation with severe abdominal pain and shock. Laparotomy was done for suspected abruptio placenta, when torsion of the uterus to 180°was diagnosed. Posterior hysterotomy was performed. She conceived the next year and was delivered at term by caesarean section. Uterine torsion is a rare complication of pregnancy and obstetricians should have this complication in mind when performing a caesarean section for undiagnosed severe abdominal pain in pregnancy. Anatomical landmarks should be defined if possible, prior to uterine incision during a caesarean section, to avoid posterior hysterotomy.
Department of Obstetrics and Gynecology, Sultan Qaboos University, Muscat, Oman.