Levotorsion of a Unicornuate Gravid Uterus Leading to Failed Induction

Abstract

The uterus in its normal state has little motility and is firmly held in place by the broad ligaments and the uterosacral ligaments. These widely distributed supports resist any tendency to torsion. The point of torsion of the uterus is fixed, occurring as a rule at the level of the uterine isthmus, rarely higher at the level of the insertion of the fallopian tubes. Until 1992, only 212 cases had been reported in literature [1]. Torsion cause venous obliteration, oedematous infiltration, distension of the uterus by blood or pus, and widespread hemorrhagic infiltration in pelvic and sub-peritoneal tissues, occlusion of the arteries may cause necrosis of tissue. The uterine torsion usually ranges from 45 to 180° but rarely extent of torsion varies between 200° and 360°, although up to 720° twists also noted [1].