Role of ultrasound in diagnosing gravid uterine incarceration.

Abstract

To summarize the ultrasound characteristics, diagnostic experiences, and pregnancy outcomes of gravid uterine incarceration. A retrospective analysis was conducted on the data of pregnant women diagnosed with gravid uterine incarceration by prenatal ultrasound at the Ultrasound Department of the Third Affiliated Hospital of Zhengzhou University from January 2020 to December 2023. Clinical data, ultrasound features, and pregnancy outcomes were analyzed. In this study, a total of 23 pregnant women were included. Of these, eight were diagnosed in early pregnancy, and 15 were diagnosed in mid-pregnancy. Seven participants had concurrent uterine fibroids, 10 had a history of abdominal or pelvic surgery, and two had ovarian cysts. A total of 13 cases presented with symptoms of urethral obstruction, three with rectal pressure symptoms, five cases with tight and stiff lower abdomen and two cases without special discomfort. Seventeen cases exhibited cervical compression with thinning and elongation, measuring approximately 39 to 73 mm. All 23 cases underwent manual or knee-chest positioning repositioning, with one case requiring surgical intervention. Ultimately, 22 cases resulted in full-term live births, one case experienced fetal demise at 24 weeks and one case experienced gravid uterine incarceration again in the third week after successful manual reduction, and manual reduction was performed again. Early diagnosis is critical for obstetric management and clinical prognosis, facilitating the successful release of the incarcerated uterus. The earlier the diagnosis, the higher the likelihood of successfully releasing the incarcerated uterus.