Uterine Torsion: A Rare Obstetric Emergency

Abstract

Uterine torsion is the rotation of the uterus by more than 45 degrees around its long axis. It is considered to be a rare and fatal emergency especially in gravid uterus which can occur at any gestational age. In most of the cases, the diagnosis is often delayed and is recognized at cesarean section. The management is to detort the uterus, deliver the baby and act upon the cause if any. The first patient was a great grand multipara with bad obstetric history presented at term with transverse lie. Bicornuate uterus with torsion was diagnosed intraoperatively for which detorsion was attempted successfully and cesarean section was performed. The second patient was a primigravida with multiple fibroids and complete placenta previa. Emergency cesarean section was performed which revealed torsion of the uterus after the delivery of baby. The uterus was then detorted and the associated intra-operative complications were managed. In both the cases, immediate corrective measures led to good feto-maternal outcomes.