A case of uterine torsion in term pregnancy associated with placental abruption and intrauterine fetal demise

Abstract

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 probably represents a once-in-a-lifetime diagnosis. Fetal mortality up to 12 % and occasional maternal mortality are reported. The authors report a case of 180 degrees dextrogyre torsion at 38 weeks of gestation complicated by placental abruption with resultant maternal hypovolemic shock and intrauterine fetal demise. Emergency cesarean section was performed. After exteriorization of the uterus the authors observed the anterior crossing over of the proper ovarian ligaments, and at that time they realised that the uterus was axially rotated by 180 degrees. They performed a counterclockwise detorsion of the uterus and confirmed a low transverse incision of the posterior wall of the organ. Intraoperative plication of the uterosacral ligaments should be performed for prevention of recurrent torsion.