Posterior Sacculation of the Uterus in a Patient Presenting With Flank Pain at 29 Weeks of Gestation

Abstract

Early diagnosis of sacculation of the uterus is necessary to limit maternal and fetal morbidity and mortality. For a detailed evaluation of the pelvic anatomy, we recommend the use of magnetic resonance imaging in the third trimester.

Thin anterior uterine wall with incomplete uterine rupture in a primigravida detected by palpation and ultrasound: a case report

“…Uterine incarceration was absent and her lower uterine segment was located in the normal position. Other conditions, such as previous surgery, a primary myometrial defect, uterine malformation or placental abnormalities are listed as possible causes of uterine sacculation [6,14]. However, in our case report, these underlying conditions were not identified.…”

“…Uterine sacculation is defined as a transitory pouch or sac-like structure developing from a portion of the gravid uterus [6]. The typical form of sacculation results from an incarcerated retroverted uterus [5,6]. A ventrally-located cervical ostium and vagina may cause physicians to suspect this diagnosis.…”

“…Uterine diverticulum has a narrow connection with the uterine cavity and a thicker wall than in sacculation [7]. While uterine sacculation is usually observed during pregnancy [6,14], diverticulum is usually detected in non-pregnant women. Uterine diverticula as complications during pregnancy are rare.…”

“…A few reports have indicated that a uterine rupture can occur in primigravida, although this is extremely rare [2,3], with etiological or risk factors including a history of uterine surgery, labor augmentation or underlying connective tissue disease [2-4]. A thin uterine wall, as a result of uterine sacculation [5,6] or uterine diverticulum [7], may also induce uterine rupture.…”

Incarceration of the retroverted uterus in the early second trimester performed by hysterotomy delivery

“…About 15% of women have a retroverted uterus prior to pregnancy, and retroversion occurs in 11% of women in the Wrst trimester of pregnancy [1]. Usually it spontaneously reverts to an upward position before the 14th week [2,3].…”