Partial rotation of the uterus up to 45 degrees is a common physiological finding during pregnancy whereas uterine torsion is pathologic and defined as rotation greater than 45 degrees. Torsion of up to 720 degrees has been reported; with most cases occurring between 90 degrees and 180 degrees. While uterine torsion in pregnancy requires emergent intervention, the incidence is unknown. Most cases of uterine torsion are diagnosed intra-operatively at emergent cesarean section following non-specific clinical presentation, such as fetal heart rate decelerations or bradycardia, severe abdominal pain, hypotension, or vaginal bleeding. In this case series, we report on two cases of one woman with gravid uterine levorotation of 180 degrees and another with gravid uterine dextrorotation of 180 degrees.
Uterine torsion, pregnancy, cesarean section
The authors report no conflict of interest.
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Gross SJ, Gnade CM, Coyne L. Diagnosis of uterine torsion during cesarean section: a case series. Proc Obstet Gynecol. 2020 Nov 10;10(1):Article 11 [6 p.]. . Free full text article.