Hemorrhagic shock due to irreducible uterine torsion in a third trimester twin pregnancy: A case report

Darido, J.; Fesquet, J Grevoul; Diari, J; Haddad, Chadia; Bouzid, N.; Hassan, Nazia; L, Khadam; Rigonnot, Luc

doi:10.29328/journal.cjog.1001055

Cited by 3 publications

(1 citation statement)

References 17 publications

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“…In our literature review, one maternal death was reported since 2006. 6 UT could reduce the uterine blood flow leading to a decrease of placental perfusion 22 and contributing to the process of IUGR and Doppler-velocimetry alterations of the reported case report. To our knowledge, this is the second case in literature suggesting this correlation.…”

Section: Discussionmentioning

confidence: 72%

Uterine torsion and intrauterine growth restriction: Case report and systematic literature review

Ferrari

Negri

et al. 2021

J of Obstet and Gynaecol

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Purpose: Uterine torsion (UT) in pregnancy is a rare condition in obstetric practice. It is defined as a rotation of the uterus of more than 45 around its long axis. Presentations are varied and, most of the time, this condition is recognized at laparotomy or cesarean section (CS). The aim of this study is to summarize the latest evidence about UT in pregnancy. Methods: A systematic research of the literature was conducted fetching all papers published from March 2006 to June 2020. We collected data regarding clinical features, treatment, and feto-maternal outcomes. Finally, we reported data of a case of UT associated with intrauterine growth restriction (IUGR) diagnosed and treated at our institution. Results: According to our search strategy, 38 articles were included. In 66% of the cases, acute symptomatology was present at the onset, most frequently abdominal pain was reported. In one-third of the cases, UT was diagnosed during CS without clinical suspicion. Only in two cases, including our case, IUGR was reported. Most (66%) of the cases presented a 180 torsion. In the majority of the cases, a CS was performed also with a deliberate or accidental posterior hysterotomy. One and six cases of maternal and fetal death were, respectively, reported. Conclusion: UT is an infrequent obstetric condition but should be considered in case of abdominal pain, vomiting, or shock presentation during pregnancy. It could lead to a reduction in uterine blood flow contributing to poor placental perfusion, even though more evidence is needed to clarify this link.

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Section: Discussionmentioning

confidence: 72%