Uterin torsion in pregnancy

Year 2014, , 15 - 17, 22.12.2014

Fazilet Boynukalın , Ayşe Aral Ömer Güler

https://doi.org/10.12808/bcs.v3i1.1033000039

Abstract

Abstract

We report a case of torsion of the pregnant uterus at 39 weeks mimicking abruption of the placenta. The patient was 43-year-old, gravida 13, parity 10, at 39 weeks with a singleton pregnancy. She was admitted to hospital by regular uterine contractions. During intrapartum care, cesarean delivery was recommended with the indication of fetal distress that suggesting the possiblity of placental abruption and emergency cesarean section was performed. The inadvertent posterolateral incision was stitched in two layers. There was no evidence of abruption and the placenta visualized as normal for the gestation. The postop care was uneventful. Our case demonstrates the difficulties of making a diagnosis of uterine torsion. Symptoms that could have suggested the diagnosis were associated placental abruption. As a result, the diagnosis of torsion was established after opening the peritoneal cavity and the retraction of the uterine venous plexus was the key point of the operation.

Keywords: Uterine torsion, pregnancy, cesarean delivery

Özet

Plasenta dekolmanını taklit eden 39 haftalık gebelikte uterus torsiyonu olgusu sunulmaktadır. Hastanın, 43 yaşında, gravida 13, parite 10, 39-haftalık tekil gebeliği vardı. Hastaneye düzenli uterin kasılmalar ile başvurmuştu. İntrapartum takip esnasında olası plasenta dekolmanı ile oluştuğu düşünülen fetal distress endikasyonu ile sezaryen önerildi ve acil sezaryen yapıldı. Farkedilmeden ve istenmeden yapılan posterolateral insizyon iki tabaka halinde dikildi. Dekolmanı düşündüren durum yoktu ve plasenta normal olarak izlendi. Postoperatif seyir normaldi. Bu olgu uterin torsiyonu tanısının zorluğunu vurgulamaktadır. Belirtiler plasenta dekolmanını düşündürmekle birlikte batına girildikten sonra uterin torsiyonu tanısı konuldu. Uterin venöz pleksusun retraksiyonu ameliyatta dikkati çeken bir bulgu idi.

Anahtar sözcükler: Uterin torsiyon, gebelik, sezaryen doğum

Keywords

Uterine torsion, pregnancy, cesarean delivery

References

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